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Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis

BACKGROUND: This study investigated the costs and outcomes of implementing cognitive behavior therapy (CBT) for chronic fatigue syndrome (CFS) in a mental health center (MHC). CBT is an evidence-based treatment for CFS that was scarcely available until now. To investigate the possibilities for wider...

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Autores principales: Scheeres, Korine, Wensing, Michel, Bleijenberg, Gijs, Severens, Johan L
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536664/
https://www.ncbi.nlm.nih.gov/pubmed/18700975
http://dx.doi.org/10.1186/1472-6963-8-175
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author Scheeres, Korine
Wensing, Michel
Bleijenberg, Gijs
Severens, Johan L
author_facet Scheeres, Korine
Wensing, Michel
Bleijenberg, Gijs
Severens, Johan L
author_sort Scheeres, Korine
collection PubMed
description BACKGROUND: This study investigated the costs and outcomes of implementing cognitive behavior therapy (CBT) for chronic fatigue syndrome (CFS) in a mental health center (MHC). CBT is an evidence-based treatment for CFS that was scarcely available until now. To investigate the possibilities for wider implementation, a pilot implementation project was set up. METHOD: Costs and effects were evaluated in a non-controlled before- and after study with an eight months time-horizon. Both the costs of performing the treatments and the costs of implementing the treatment program were included in the analysis. The implementation interventions included: informing general practitioners (GPs) and CFS patients, training therapists, and instructing the MHC employees. Given the non-controlled design, cost outcome ratios (CORs) and their acceptability curves were analyzed. Analyses were done from a health care perspective and from a societal perspective. Bootstrap analyses were performed to estimate the uncertainty around the cost and outcome results. RESULTS: 125 CFS patients were included in the study. After treatment 37% had recovered from CFS and the mean gained QALY was 0.03. Costs of patients' health care and productivity losses had decreased significantly. From the societal perspective the implementation led to cost savings and to higher health states for patients, indicating dominancy. From the health care perspective the implementation revealed overall costs of €5.320 per recovered patient, with an acceptability curve showing a 100% probability for a positive COR at a willingness to pay threshold of €6.500 per recovered patient. CONCLUSION: Implementing CBT for CFS in a MHC appeared to have a favorable cost outcome ratio (COR) from a societal perspective. From a health care perspective the COR depended on how much a recovered CFS patient is being valued. The strength of the evidence was limited by the non-controlled design. The outcomes of this study might facilitate health care providers when confronted with the decision whether or not to adopt CBT for CFS in their institution.
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spelling pubmed-25366642008-09-16 Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis Scheeres, Korine Wensing, Michel Bleijenberg, Gijs Severens, Johan L BMC Health Serv Res Research Article BACKGROUND: This study investigated the costs and outcomes of implementing cognitive behavior therapy (CBT) for chronic fatigue syndrome (CFS) in a mental health center (MHC). CBT is an evidence-based treatment for CFS that was scarcely available until now. To investigate the possibilities for wider implementation, a pilot implementation project was set up. METHOD: Costs and effects were evaluated in a non-controlled before- and after study with an eight months time-horizon. Both the costs of performing the treatments and the costs of implementing the treatment program were included in the analysis. The implementation interventions included: informing general practitioners (GPs) and CFS patients, training therapists, and instructing the MHC employees. Given the non-controlled design, cost outcome ratios (CORs) and their acceptability curves were analyzed. Analyses were done from a health care perspective and from a societal perspective. Bootstrap analyses were performed to estimate the uncertainty around the cost and outcome results. RESULTS: 125 CFS patients were included in the study. After treatment 37% had recovered from CFS and the mean gained QALY was 0.03. Costs of patients' health care and productivity losses had decreased significantly. From the societal perspective the implementation led to cost savings and to higher health states for patients, indicating dominancy. From the health care perspective the implementation revealed overall costs of €5.320 per recovered patient, with an acceptability curve showing a 100% probability for a positive COR at a willingness to pay threshold of €6.500 per recovered patient. CONCLUSION: Implementing CBT for CFS in a MHC appeared to have a favorable cost outcome ratio (COR) from a societal perspective. From a health care perspective the COR depended on how much a recovered CFS patient is being valued. The strength of the evidence was limited by the non-controlled design. The outcomes of this study might facilitate health care providers when confronted with the decision whether or not to adopt CBT for CFS in their institution. BioMed Central 2008-08-13 /pmc/articles/PMC2536664/ /pubmed/18700975 http://dx.doi.org/10.1186/1472-6963-8-175 Text en Copyright © 2008 Scheeres et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Scheeres, Korine
Wensing, Michel
Bleijenberg, Gijs
Severens, Johan L
Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis
title Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis
title_full Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis
title_fullStr Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis
title_full_unstemmed Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis
title_short Implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis
title_sort implementing cognitive behavior therapy for chronic fatigue syndrome in mental health care: a costs and outcomes analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536664/
https://www.ncbi.nlm.nih.gov/pubmed/18700975
http://dx.doi.org/10.1186/1472-6963-8-175
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