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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 supported treatm...

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Autores principales: Romero-Sanchiz, Pablo, Nogueira-Arjona, Raquel, García-Ruiz, Antonio, Luciano, Juan V., García Campayo, Javier, Gili, Margalida, Botella, Cristina, Baños, Rosa, Castro, Adoración, López-Del-Hoyo, Yolanda, Pérez Ara, Mª Ángeles, Modrego-Alarcón, Marta, Mayoral Cleríes, Fermín
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328395/
https://www.ncbi.nlm.nih.gov/pubmed/28241025
http://dx.doi.org/10.1371/journal.pone.0172741
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author Romero-Sanchiz, Pablo
Nogueira-Arjona, Raquel
García-Ruiz, Antonio
Luciano, Juan V.
García Campayo, Javier
Gili, Margalida
Botella, Cristina
Baños, Rosa
Castro, Adoración
López-Del-Hoyo, Yolanda
Pérez Ara, Mª Ángeles
Modrego-Alarcón, Marta
Mayoral Cleríes, Fermín
author_facet Romero-Sanchiz, Pablo
Nogueira-Arjona, Raquel
García-Ruiz, Antonio
Luciano, Juan V.
García Campayo, Javier
Gili, Margalida
Botella, Cristina
Baños, Rosa
Castro, Adoración
López-Del-Hoyo, Yolanda
Pérez Ara, Mª Ángeles
Modrego-Alarcón, Marta
Mayoral Cleríes, Fermín
author_sort Romero-Sanchiz, Pablo
collection PubMed
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
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spelling pubmed-53283952017-03-09 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 Romero-Sanchiz, Pablo Nogueira-Arjona, Raquel García-Ruiz, Antonio Luciano, Juan V. García Campayo, Javier Gili, Margalida Botella, Cristina Baños, Rosa Castro, Adoración López-Del-Hoyo, Yolanda Pérez Ara, Mª Ángeles Modrego-Alarcón, Marta Mayoral Cleríes, Fermín PLoS One Research Article 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 Public Library of Science 2017-02-27 /pmc/articles/PMC5328395/ /pubmed/28241025 http://dx.doi.org/10.1371/journal.pone.0172741 Text en © 2017 Romero-Sanchiz et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Romero-Sanchiz, Pablo
Nogueira-Arjona, Raquel
García-Ruiz, Antonio
Luciano, Juan V.
García Campayo, Javier
Gili, Margalida
Botella, Cristina
Baños, Rosa
Castro, Adoración
López-Del-Hoyo, Yolanda
Pérez Ara, Mª Ángeles
Modrego-Alarcón, Marta
Mayoral Cleríes, Fermín
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 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328395/
https://www.ncbi.nlm.nih.gov/pubmed/28241025
http://dx.doi.org/10.1371/journal.pone.0172741
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