Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol
Abstract Background Given the high prevalence of Cluster-C Personality Disorders (PDs) in clinical populations, disease burden, high societal costs and poor prognosis of comorbid disorders, a major gain in health care can be achieved if Cluster-C PDs are adequately treated. The only controlled cost-...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-022-04248-9 |
| _version_ | 1826900697786875904 |
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| author | Iuno Z. Groot Anne-Sophie S. M. Venhuizen Nathan Bachrach Simone Walhout Bregje de Moor Kasper Nikkels Susanne Dalmeijer Myrte Maarschalkerweerd Joël R. van Aalderen Hinde de Lange Renske Wichers Agatha Ph. Hollander Silvia M. A. A. Evers Raoul P. P. P. Grasman Arnoud Arntz |
| author_facet | Iuno Z. Groot Anne-Sophie S. M. Venhuizen Nathan Bachrach Simone Walhout Bregje de Moor Kasper Nikkels Susanne Dalmeijer Myrte Maarschalkerweerd Joël R. van Aalderen Hinde de Lange Renske Wichers Agatha Ph. Hollander Silvia M. A. A. Evers Raoul P. P. P. Grasman Arnoud Arntz |
| author_sort | Iuno Z. Groot |
| collection | DOAJ |
| description | Abstract Background Given the high prevalence of Cluster-C Personality Disorders (PDs) in clinical populations, disease burden, high societal costs and poor prognosis of comorbid disorders, a major gain in health care can be achieved if Cluster-C PDs are adequately treated. The only controlled cost-effectiveness study published so far found Individual Schema Therapy (IST) to be superior to Treatment as Usual (TAU). Group ST (GST) might improve cost-effectiveness as larger numbers can be treated in (>50%) less time compared to IST. However, to date there is no RCT supporting its (cost-) effectiveness. The overall aim of this study is to assess the evidence for GST for Cluster-C PDs and to improve treatment allocation for individual patients. Three main questions are addressed: 1) Is GST for Cluster-C PDs (cost-)effective compared to TAU? 2) Is GST for Cluster-C PDs (cost-) effective compared to IST? 3) Which patient-characteristics predict better response to GST, IST, or TAU? Methods In a multicenter RCT, the treatment conditions GST, IST, and TAU are compared in 378 Cluster-C PD patients within 10 sites. GST and IST follow treatment protocols and are completed within 1 year. TAU is the optimal alternative treatment available at the site according to regular procedures. Severity of the Cluster-C PD is the primary outcome, assessed with clinical interviews by independent raters blind for treatment. Functioning and wellbeing are important secondary outcomes. Assessments take place at week 0 (baseline), 17 (mid-GST), 34 (post-GST), 51 (post-booster sessions of GST), and 2 years (FU). Patient characteristics predicting better response to a specific treatment are studied, e.g., childhood trauma, autistic features, and introversion. A tool supporting patients and clinicians in matching treatment to patient will be developed. An economic evaluation investigates the cost-effectiveness and cost-utility from a societal perspective. A process evaluation by qualitative methods explores experiences of participants, loved ones and therapists regarding recovery, quality of life, and improving treatment. Discussion This study will determine the (cost-)effectiveness of treatments for Cluster-C PDs regarding treatment type as well as optimal matching of patient to treatment and deliver insight into which aspects help Cluster-C-PD patients recover and create a fulfilling life. Trial registration Dutch Trial Register: NL9209 . Registered on 28-01-2021, |
| first_indexed | 2024-04-13T23:50:04Z |
| format | Article |
| id | doaj.art-939fc5d5fec44b2f8991d2c6dc2e9b73 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2025-02-17T07:11:34Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
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| series | BMC Psychiatry |
| spelling | doaj.art-939fc5d5fec44b2f8991d2c6dc2e9b732025-01-05T12:42:37ZengBMCBMC Psychiatry1471-244X2022-10-0122111810.1186/s12888-022-04248-9Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocolIuno Z. Groot0Anne-Sophie S. M. Venhuizen1Nathan Bachrach2Simone Walhout3Bregje de Moor4Kasper Nikkels5Susanne Dalmeijer6Myrte Maarschalkerweerd7Joël R. van Aalderen8Hinde de Lange9Renske Wichers10Agatha Ph. Hollander11Silvia M. A. A. Evers12Raoul P. P. P. Grasman13Arnoud Arntz14Department of Clinical Psychology, University of AmsterdamDepartment of Clinical Psychology, University of AmsterdamDepartment of medical and clinical psychology, Tilburg UniversityGGZ-Oost Brabant, Department of Personality DisordersGGZ-Oost Brabant, Department of Personality DisordersPsyQ AmsterdamPsyQ ZaandamPsyQ RotterdamPsyQ UtrechtEmergisIPGGZ VeendamIPGGZ GroningenDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI) Maastricht UniversityDepartment of Psychological Methods, University of AmsterdamDepartment of Clinical Psychology, University of AmsterdamAbstract Background Given the high prevalence of Cluster-C Personality Disorders (PDs) in clinical populations, disease burden, high societal costs and poor prognosis of comorbid disorders, a major gain in health care can be achieved if Cluster-C PDs are adequately treated. The only controlled cost-effectiveness study published so far found Individual Schema Therapy (IST) to be superior to Treatment as Usual (TAU). Group ST (GST) might improve cost-effectiveness as larger numbers can be treated in (>50%) less time compared to IST. However, to date there is no RCT supporting its (cost-) effectiveness. The overall aim of this study is to assess the evidence for GST for Cluster-C PDs and to improve treatment allocation for individual patients. Three main questions are addressed: 1) Is GST for Cluster-C PDs (cost-)effective compared to TAU? 2) Is GST for Cluster-C PDs (cost-) effective compared to IST? 3) Which patient-characteristics predict better response to GST, IST, or TAU? Methods In a multicenter RCT, the treatment conditions GST, IST, and TAU are compared in 378 Cluster-C PD patients within 10 sites. GST and IST follow treatment protocols and are completed within 1 year. TAU is the optimal alternative treatment available at the site according to regular procedures. Severity of the Cluster-C PD is the primary outcome, assessed with clinical interviews by independent raters blind for treatment. Functioning and wellbeing are important secondary outcomes. Assessments take place at week 0 (baseline), 17 (mid-GST), 34 (post-GST), 51 (post-booster sessions of GST), and 2 years (FU). Patient characteristics predicting better response to a specific treatment are studied, e.g., childhood trauma, autistic features, and introversion. A tool supporting patients and clinicians in matching treatment to patient will be developed. An economic evaluation investigates the cost-effectiveness and cost-utility from a societal perspective. A process evaluation by qualitative methods explores experiences of participants, loved ones and therapists regarding recovery, quality of life, and improving treatment. Discussion This study will determine the (cost-)effectiveness of treatments for Cluster-C PDs regarding treatment type as well as optimal matching of patient to treatment and deliver insight into which aspects help Cluster-C-PD patients recover and create a fulfilling life. Trial registration Dutch Trial Register: NL9209 . Registered on 28-01-2021,https://doi.org/10.1186/s12888-022-04248-9Cluster-C personality disorderRandomized controlled trialGroup schema therapyIndividual schema therapyEconomic evaluationPersonalized care |
| spellingShingle | Iuno Z. Groot Anne-Sophie S. M. Venhuizen Nathan Bachrach Simone Walhout Bregje de Moor Kasper Nikkels Susanne Dalmeijer Myrte Maarschalkerweerd Joël R. van Aalderen Hinde de Lange Renske Wichers Agatha Ph. Hollander Silvia M. A. A. Evers Raoul P. P. P. Grasman Arnoud Arntz Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol BMC Psychiatry Cluster-C personality disorder Randomized controlled trial Group schema therapy Individual schema therapy Economic evaluation Personalized care |
| title | Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol |
| title_full | Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol |
| title_fullStr | Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol |
| title_full_unstemmed | Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol |
| title_short | Design of an RCT on cost-effectiveness of group schema therapy versus individual schema therapy for patients with Cluster-C personality disorder: the QUEST-CLC study protocol |
| title_sort | design of an rct on cost effectiveness of group schema therapy versus individual schema therapy for patients with cluster c personality disorder the quest clc study protocol |
| topic | Cluster-C personality disorder Randomized controlled trial Group schema therapy Individual schema therapy Economic evaluation Personalized care |
| url | https://doi.org/10.1186/s12888-022-04248-9 |
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