6533b82bfe1ef96bd128d94d
RESEARCH PRODUCT
Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multicenter, three-armed randomized controlled trial conducted in primary care
Mª ÁNgeles Pérez AraCristina BotellaAdoración CastroMargalida GiliRaquel Nogueira-arjonaJavier García CampayoPablo Romero-sanchizAntonio García-ruizRosa M. BañosRosa M. BañosFermín Mayoral CleríesYolanda López Del HoyoJuan V. LucianoMarta Modrego-alarcónsubject
MaleSpanish PeopleEconomicsPsychological interventionSocial SciencesSeverity of Illness Indexlaw.invention:Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]Learning and Memory0302 clinical medicineHispanoamericanosEthnicitiesPsychologyAnálisis de intención de tratarlcsh:Sciencemediana edadancianoDepressionAntidepressantsadulto:Health Care::Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health Care [Medical Subject Headings]Humanosadulto joven:Health Care::Health Care Quality Access and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic::Intention to Treat Analysis [Medical Subject Headings]Psicoterapia:Information Science::Information Science::Computing Methodologies::Computer Systems::Computer Communication Networks::Internet [Medical Subject Headings]medicine.medical_specialtyEvidence-based practiceGrupos control03 medical and health sciences:Health Care::Health Care Economics and Organizations::Economics::Costs and Cost Analysis::Cost-Benefit Analysis [Medical Subject Headings]Drug TherapySeverity of illnessHumans:Persons::Persons::Age Groups::Adult [Medical Subject Headings]psicoterapiaAgedPharmacologyDepressive DisorderDepressive Disorder MajorInternetPrimary Health CareMood Disorderslcsh:RBiology and Life SciencesSonrisa030227 psychiatryHealth CareAnálisis costo-beneficio:Check Tags::Female [Medical Subject Headings]Economic evaluationlcsh:QPopulation GroupingsNeuroscienceGerontologyFinancial ManagementCost effectivenessCost-Benefit Analysishumanosadolescentelcsh:MedicineTrastorno depresivoRandomized controlled triallawDepresiónMedicine and Health Sciences030212 general & internal medicineMultidisciplinaryAdultoPharmaceuticsresultado del tratamientoFemeninoDrugsCost-effectiveness analysisMiddle AgedTelemedicineTreatment OutcomeSociedades científicasFemale:Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Communication::Nonverbal Communication::Facial Expression::Smiling [Medical Subject Headings]Estudios de seguimiento:Persons::Persons::Population Groups::Ethnic Groups::Hispanic Americans [Medical Subject Headings]telemedicinaResearch ArticleAdultAdolescent:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Methods::Research Design::Control Groups [Medical Subject Headings]:Psychiatry and Psychology::Behavioral Disciplines and Activities::Psychotherapy [Medical Subject Headings]Cost-Effectiveness AnalysisMEDLINEYoung Adulttrastorno depresivoAtención primaria de saludMental Health and PsychiatryIndirect CostsmedicineLearningíndice de gravedad de la enfermedadPrimary Care:Psychiatry and Psychology::Mental Disorders::Mood Disorders::Depressive Disorder [Medical Subject Headings]:Health Care::Health Care Economics and Organizations::Organizations::Societies::Societies Scientific [Medical Subject Headings]Cognitive Behavioral Therapybusiness.industryCognitive Psychology:Health Care::Health Care Quality Access and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Follow-Up Studies [Medical Subject Headings]Economic AnalysisPsychotherapyPeople and PlacesPhysical therapyCognitive Science:Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Behavioral Symptoms::Depression [Medical Subject Headings]businessFinancedescription
Depression is one of the most common mental disorders and will become one of the leading causes of disability in the world. Internet-based CBT programs for depression have been classified as well established following the American Psychological Association criteria for empirically supported treatments. The aim of this study is to analyze the cost effectiveness at 12-month follow-up of the Internet-based CBT program Smiling is fun with (LITG) and without psychotherapist support (TSG) compared to usual care. The perspective used in our analysis is societal. A sample of 296 depressed patients (mean age of 43.04 years; 76% female; BDI-II mean score = 22.37) from primary care services in four Spanish regions were randomized in the RCT. The complete case and intention-to-treat (ITT) perspectives were used for the analyses. The results demonstrated that both Internet-based CBT interventions exhibited cost utility and cost effectiveness compared with a control group. The complete case analyses revealed an incremental cost- effectiveness ratio (ICER) of (sic)-169.50 and an incremental cost-utility ratio (ICUR) of (sic)-11389.66 for the TSG group and an ICER of (sic)-104.63 and an ICUR of (sic)-6380.86 for the LITG group. The ITT analyses found an ICER of (sic)-98.37 and an ICUR of (sic)- 5160.40 for the TSG group and an ICER of (sic)-9.91 and an ICUR of (sic)496.72 for the LITG group. In summary, the results of this study indicate that the two Internet-based CBT interventions are appropriate from both economic and clinical perspectives for depressed patients in the Spanish primary care system. These interventions not only help patients to improve clinically but also generate societal savings.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-02-27 |