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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
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008240508s2024 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:238700867
009oai:DiVA.org:uu-530861
009oai:prod.swepub.kib.ki.se:158242780
0247 a https://lup.lub.lu.se/record/e1edebfc-1be7-44c1-81cb-068a68349d6b2 URI
0247 a https://doi.org/10.1001/jamanetworkopen.2024.84682 DOI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:2387008672 URI
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-5308612 URI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1582427802 URI
040 a (SwePub)lud (SwePub)kid (SwePub)uud (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a art2 swepub-publicationtype
072 7a ref2 swepub-contenttype
1001 a Andrén, Peru Karolinska Institutet,Karolinska Institute,Lund University,Lunds universitet,Barn- och ungdomspsykiatri,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Innovations in pediatric mental health,Forskargrupper vid Lunds universitet,Child and Adolescent Psychiatry,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Stockholm Regional Council,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.;Lund Univ, Dept Clin Sci, Lund, Sweden.4 aut0 (Swepub:lu)pe6177an
2451 0a Internet-Delivered Exposure and Response Prevention for Pediatric Tourette Syndrome : 12-Month Follow-Up of a Randomized Clinical Trial
264 1b American Medical Association (AMA),c 2024
520 a IMPORTANCE: Behavior therapy is a recommended intervention for Tourette syndrome (TS) and chronic tic disorder (CTD), but availability is limited and long-term effects are uncertain.OBJECTIVE: To investigate the long-term efficacy and cost-effectiveness of therapist-supported, internet-delivered exposure and response prevention (ERP) vs psychoeducation for youths with TS or CTD.DESIGN, SETTING, AND PARTICIPANTS: This 12-month controlled follow-up of a parallel group, superiority randomized clinical trial was conducted at a research clinic in Stockholm, Sweden, with nationwide recruitment. In total, 221 participants aged 9 to 17 years with TS or CTD were enrolled between April 26, 2019, and April 9, 2021, of whom 208 (94%) provided 12-month follow-up data. Final follow-up data were collected on June 29, 2022. Outcome assessors were masked to treatment allocation throughout the study.INTERVENTIONS: A total of 111 participants were originally randomly allocated to 10 weeks of therapist-supported, internet-delivered ERP and 110 participants to therapist-supported, internet-delivered psychoeducation.MAIN OUTCOMES AND MEASURES: The primary outcome was within-group change in tic severity, measured by the Total Tic Severity Score of the Yale Global Tic Severity Scale (YGTSS-TTSS), from the 3-month follow-up to the 12-month follow-up. Treatment response was defined as 1 (very much improved) or 2 (much improved) on the Clinical Global Impression-Improvement scale. Analyses were intention-to-treat and followed the plan prespecified in the published study protocol. A health economic evaluation was performed from 3 perspectives: health care organization (including direct costs for treatment provided in the study), health care sector (additionally including health care resource use outside of the study), and societal (additionally including costs beyond health care [eg, parent's absenteeism from work]).RESULTS: In total, 221 participants were recruited (mean [SD] age, 12.1 [2.3] years; 152 [69%] male). According to the YGTSS-TTSS, there were no statistically significant changes in tic severity from the 3-month to the 12-month follow-up in either group (ERP coefficient, -0.52 [95% CI, -1.26 to 0.21]; P = .16; psychoeducation coefficient, 0.00 [95% CI, -0.78 to 0.78]; P > .99). A secondary analysis including all assessment points (baseline to 12-month follow-up) showed no statistically significant between-group difference in tic severity from baseline to the 12-month follow-up (coefficient, -0.38 [95% CI, -1.11 to 0.35]; P = .30). Treatment response rates were similar in both groups (55% in ERP and 50% in psychoeducation; odds ratio, 1.25 [95% CI, 0.73-2.16]; P = .42) at the 12-month follow-up. The health economic evaluation showed that, from a health care sector perspective, ERP produced more quality-adjusted life years (0.01 [95% CI, -0.01 to 0.03]) and lower costs (adjusted mean difference -$84.48 [95% CI, -$440.20 to $977.60]) than psychoeducation at the 12-month follow-up. From the health care organization and societal perspectives, ERP produced more quality-adjusted life years at higher costs, with 65% to 78% probability of ERP being cost-effective compared with psychoeducation when using a willingness-to-pay threshold of US $79 000.CONCLUSIONS AND RELEVANCE: There were no statistically significant changes in tic severity from the 3-month through to the 12-month follow-up in either group. The ERP intervention was not superior to psychoeducation at any time point. While ERP was not superior to psychoeducation alone in reducing tic severity at the end of the follow-up period, ERP is recommended for clinical implementation due to its likely cost-effectiveness and support from previous literature.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03916055.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Psykiatri0 (SwePub)302152 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Psychiatry0 (SwePub)302152 hsv//eng
653 a Humans
653 a Tourette Syndrome/therapy
653 a Male
653 a Female
653 a Child
653 a Adolescent
653 a Follow-Up Studies
653 a Cost-Benefit Analysis
653 a Internet
653 a Sweden
653 a Treatment Outcome
653 a Internet-Based Intervention
653 a Behavior Therapy/methods
7001 a Sampaio, Filipa,c PhD,d 1985-u Uppsala universitet,Uppsala University,Socialmedicin/CHAP4 aut0 (Swepub:uu)filsa251
7001 a Ringberg, Heleneu Stockholm Regional Council,Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.4 aut
7001 a Wachtmeister, Verau Karolinska Institutet,Karolinska Institute,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.4 aut
7001 a Warnström, Moau Karolinska Institutet,Karolinska Institute,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.4 aut
7001 a Isomura, Kayokou Karolinska Institutet,Karolinska Institute,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.4 aut
7001 a Aspvall, Kristinau Karolinska Institutet,Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.4 aut
7001 a Lenhard, Fabianu Karolinska Institutet,Karolinska Institute,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.4 aut
7001 a Hall, Charlotte Lu University of Nottingham,Univ Nottingham, Natl Inst Hlth & Care Res MindTech MedTech Coopera, Sch Med, Mental Hlth & Clin Neurosci, Nottingham, England.;Univ Nottingham, Natl Inst Hlth & Care Res Nottingham Biomed Res Ct, Inst Mental Hlth, Mental Hlth & Clin Neurosci, Nottingham, England.4 aut
7001 a Davies, E Bethanu University of Nottingham,Univ Nottingham, Natl Inst Hlth & Care Res MindTech MedTech Coopera, Sch Med, Mental Hlth & Clin Neurosci, Nottingham, England.4 aut
7001 a Murphy, Tarau University College London,UCL, Great Ormond St Inst Child Hlth, London, England.;Great Ormond St Hosp Sick Children, Psychol & Mental Hlth Serv, Great Ormond St, London, England.4 aut
7001 a Hollis, Chrisu University of Nottingham,Univ Nottingham, Natl Inst Hlth & Care Res MindTech MedTech Coopera, Sch Med, Mental Hlth & Clin Neurosci, Nottingham, England.;Univ Nottingham, Natl Inst Hlth & Care Res Nottingham Biomed Res Ct, Inst Mental Hlth, Mental Hlth & Clin Neurosci, Nottingham, England.4 aut
7001 a Feldman, Inna,c Docent,d 1951-u Uppsala universitet,Uppsala University,Socialmedicin/CHAP4 aut0 (Swepub:uu)ife21721
7001 a Bottai, Matteou Karolinska Institutet,Karolinska Institute,Karolinska Inst, Inst Environm Med, Unit Biostat, Stockholm, Sweden.4 aut
7001 a Serlachius, Evau Karolinska Institutet,Karolinska Institute,Lund University,Lunds universitet,Barn- och ungdomspsykiatri,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Innovations in pediatric mental health,Forskargrupper vid Lunds universitet,Child and Adolescent Psychiatry,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Lund Univ, Dept Clin Sci, Lund, Sweden.4 aut0 (Swepub:lu)ev1305se
7001 a Andersson, Eriku Karolinska Institutet,Karolinska Institute,Stockholm Regional Council,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.4 aut
7001 a Fernández de la Cruz, Lorenau Karolinska Institutet,Karolinska Institute,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.4 aut
7001 a Mataix-Cols, Davidu Karolinska Institutet,Karolinska Institute,Lund University,Lunds universitet,Innovations in pediatric mental health,Forskargrupper vid Lunds universitet,Lund University Research Groups,Stockholm Regional Council,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Gävlegatan 22, S-11330 Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden.;Lund Univ, Dept Clin Sci, Lund, Sweden.4 aut0 (Swepub:lu)da5182ma
7102 a Barn- och ungdomspsykiatrib Sektion IV4 org
7730 t JAMA Network Opend : American Medical Association (AMA)g 7:5q 7:5x 2574-3805
8564 u http://dx.doi.org/10.1001/jamanetworkopen.2024.8468x freey FULLTEXT
8564 u https://doi.org/10.1001/jamanetworkopen.2024.8468y Fulltext
8564 u https://uu.diva-portal.org/smash/get/diva2:1867910/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
8564 8u https://lup.lub.lu.se/record/e1edebfc-1be7-44c1-81cb-068a68349d6b
8564 8u https://doi.org/10.1001/jamanetworkopen.2024.8468
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:238700867
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-530861
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:158242780

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