Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder: results from a randomised controlled trial

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Lenhard, FabianKarolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Healthcare Serv, Stockholm, Sweden. (author)

Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder : results from a randomised controlled trial

Article/chapterEnglish2017

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2017-05-17
BMJ,2017
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LIBRIS-ID:oai:DiVA.org:uu-329120
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-329120URI
https://doi.org/10.1136/bmjopen-2016-015246DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:136056589URI

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Language:English
Summary in:English

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Corrections: http://dx.doi.org/10.1136/bmjopen-2016-015246corr1
Objectives To evaluate the cost-effectiveness of a therapist-guided internet-delivered cognitive behaviour therapy (ICBT) intervention for adolescents with obsessive-compulsive disorder (OCD) compared with untreated patients on a waitlist. Design Single-blinded randomised controlled trial. Setting A research clinic within the regular child and adolescent mental health service in Stockholm, Sweden. Participants Sixty-seven adolescents (12-17 years) with a Diagnostic and Statistical Manual of Mental Disorders Fifth Edition diagnosis of OCD. Interventions Either a 12-week, therapist-guided ICBT intervention or a wait list condition of equal duration. Primary outcome measures Cost data were collected at baseline and after treatment, including healthcare use, supportive resources, prescription drugs, prescription-free drugs, school absence and productivity loss, as well as the cost of ICBT. Health outcomes were defined as treatment responder rate and quality-adjusted life years gain. Bootstrapped mixed model analyses were conducted comparing incremental costs and health outcomes between the groups from the societal and healthcare perspectives. Results Compared with waitlist control, ICBT generated substantial societal cost savings averaging US$-144.98 (95% CI -159.79 to -130.16) per patient. The cost reductions were mainly driven by reduced healthcare use in the ICBT group. From the societal perspective, the probability of ICBT being cost saving compared with waitlist control was approximately 60%. From the healthcare perspective, the cost per additional responder to ICBT compared with waitlist control was approximately US$78. Conclusions The results suggest that therapist-guided ICBT is a cost-effective treatment and results in societal cost savings, compared with patients who do not receive evidence-based treatment. Since, at present, most patients with OCD do not have access to evidence-based treatments, the results have important implications for the increasingly strained national and healthcare budgets. Future studies should compare the cost-effectiveness of ICBT with regular face-to-face CBT.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Pediatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Pediatrics hsv//eng
SAMHÄLLSVETENSKAP Psykologi Tillämpad psykologi hsv//swe
SOCIAL SCIENCES Psychology Applied Psychology hsv//eng

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Ssegonja, RichardUppsala universitet,Institutionen för kvinnors och barns hälsa,Socialmedicin/CHAP(Swepub:uu)ricss733 (author)
Andersson, ErikKarolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden. (author)
Feldman, Inna,1951-Uppsala universitet,Institutionen för kvinnors och barns hälsa,Socialmedicin/CHAP(Swepub:uu)ife21721 (author)
Ruck, ChristianKarolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Healthcare Serv, Stockholm, Sweden. (author)
Mataix-Cols, DavidKarolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Healthcare Serv, Stockholm, Sweden. (author)
Serlachius, EvaKarolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Healthcare Serv, Stockholm, Sweden. (author)
Karolinska InstitutetKarolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Healthcare Serv, Stockholm, Sweden. (creator_code:org_t)

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

SOCIAL SCIENCES: SOCIAL SCIENCES; and Psychology; and Applied Psycholo ...

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