Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care.
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 suppor...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5328395?pdf=render |
| _version_ | 1831654332584427520 |
|---|---|
| author | Pablo Romero-Sanchiz Raquel Nogueira-Arjona Antonio García-Ruiz Juan V Luciano Javier García Campayo Margalida Gili Cristina Botella Rosa Baños Adoración Castro Yolanda López-Del-Hoyo Mª Ángeles Pérez Ara Marta Modrego-Alarcón Fermín Mayoral Cleríes |
| author_facet | Pablo Romero-Sanchiz Raquel Nogueira-Arjona Antonio García-Ruiz Juan V Luciano Javier García Campayo Margalida Gili Cristina Botella Rosa Baños Adoración Castro Yolanda López-Del-Hoyo Mª Ángeles Pérez Ara Marta Modrego-Alarcón Fermín Mayoral Cleríes |
| author_sort | Pablo Romero-Sanchiz |
| collection | DOAJ |
| description | 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 €-169.50 and an incremental cost-utility ratio (ICUR) of €-11389.66 for the TSG group and an ICER of €-104.63 and an ICUR of €-6380.86 for the LITG group. The ITT analyses found an ICER of €-98.37 and an ICUR of €-5160.40 for the TSG group and an ICER of €-9.91 and an ICUR of €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. TRIAL REGISTRATION:clinicaltrials.gov NCT01611818. |
| first_indexed | 2024-12-19T16:25:51Z |
| format | Article |
| id | doaj.art-686d8198c3744b1a8530718384c94e78 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-19T16:25:51Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-686d8198c3744b1a8530718384c94e782022-12-21T20:14:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01122e017274110.1371/journal.pone.0172741Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care.Pablo Romero-SanchizRaquel Nogueira-ArjonaAntonio García-RuizJuan V LucianoJavier García CampayoMargalida GiliCristina BotellaRosa BañosAdoración CastroYolanda López-Del-HoyoMª Ángeles Pérez AraMarta Modrego-AlarcónFermín Mayoral CleríesDepression 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 €-169.50 and an incremental cost-utility ratio (ICUR) of €-11389.66 for the TSG group and an ICER of €-104.63 and an ICUR of €-6380.86 for the LITG group. The ITT analyses found an ICER of €-98.37 and an ICUR of €-5160.40 for the TSG group and an ICER of €-9.91 and an ICUR of €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. TRIAL REGISTRATION:clinicaltrials.gov NCT01611818.http://europepmc.org/articles/PMC5328395?pdf=render |
| spellingShingle | Pablo Romero-Sanchiz Raquel Nogueira-Arjona Antonio García-Ruiz Juan V Luciano Javier García Campayo Margalida Gili Cristina Botella Rosa Baños Adoración Castro Yolanda López-Del-Hoyo Mª Ángeles Pérez Ara Marta Modrego-Alarcón Fermín Mayoral Cleríes Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care. PLoS ONE |
| title | Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care. |
| title_full | Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care. |
| title_fullStr | Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care. |
| title_full_unstemmed | Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care. |
| title_short | Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care. |
| title_sort | economic evaluation of a guided and unguided internet based cbt intervention for major depression results from a multi center three armed randomized controlled trial conducted in primary care |
| url | http://europepmc.org/articles/PMC5328395?pdf=render |
| work_keys_str_mv | AT pabloromerosanchiz economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT raquelnogueiraarjona economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT antoniogarciaruiz economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT juanvluciano economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT javiergarciacampayo economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT margalidagili economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT cristinabotella economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT rosabanos economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT adoracioncastro economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT yolandalopezdelhoyo economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT maangelesperezara economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT martamodregoalarcon economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare AT ferminmayoralcleries economicevaluationofaguidedandunguidedinternetbasedcbtinterventionformajordepressionresultsfromamulticenterthreearmedrandomizedcontrolledtrialconductedinprimarycare |