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Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation
BACKGROUND: Although effective treatments are available to address the cognitive deficits experienced by individuals with first-episode psychosis, provision of such treatments within Coordinated Specialty Care (CSC) programs is rare. One factor that may contribute to this is uncertainty about the co...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247178/ https://www.ncbi.nlm.nih.gov/pubmed/34210341 http://dx.doi.org/10.1186/s12962-021-00292-6 |
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author | Breitborde, Nicholas J. K. Bell, Emily K. Woolverton, Cindy Pine, Jacob G. Waslter, Heather Moe, Aubrey M. |
author_facet | Breitborde, Nicholas J. K. Bell, Emily K. Woolverton, Cindy Pine, Jacob G. Waslter, Heather Moe, Aubrey M. |
author_sort | Breitborde, Nicholas J. K. |
collection | PubMed |
description | BACKGROUND: Although effective treatments are available to address the cognitive deficits experienced by individuals with first-episode psychosis, provision of such treatments within Coordinated Specialty Care (CSC) programs is rare. One factor that may contribute to this is uncertainty about the cost implications of providing cognitive-enhancing treatments within the American mental healthcare system. The aim of this study is to complete a naturalistic evaluation of the cost utility of incorporating two different cognitive-enhancing interventions within an American CSC program. METHODS: Participants included 66, predominately white (75.38%), individuals with first-episode psychosis (19 women and 47 men) with a mean age of 22.71 years. Quality adjusted life years (QALYs) and cost of care were tracked among these individuals during their participation in a CSC program. These data were compared among three groups of participants during their first six months of care: (i) individuals who participated in metacognitive remediation therapy (MCR), (ii) individuals who participated in computerized cognitive remediation (CCR), and (iii) individuals who participated in no cognitive-enhancing intervention. RESULTS: Participation in MCR, but not CCR, was associated with larger gains in QALYs than participation in no cognitive-enhancing intervention within a CSC program. Moreover, data support the cost utility of MCR as compared to CCR or no-cognitive enhancing intervention within a CSC program. Conversely, CCR did not appear to be a cost-effective addition to CSC services. CONCLUSIONS: Our results highlight the potential cost utility of incorporating MCR within CSC programs for individuals with first-episode psychosis. However, given study limitations, these results should be interpreted cautiously until replicated by large, randomized controlled trials. Trial Registration ClinicalTrials.gov Identifier NCT01570972, registered April 4, 2012, Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01570972?term=breitborde&draw=2&rank=6. |
format | Online Article Text |
id | pubmed-8247178 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-82471782021-07-06 Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation Breitborde, Nicholas J. K. Bell, Emily K. Woolverton, Cindy Pine, Jacob G. Waslter, Heather Moe, Aubrey M. Cost Eff Resour Alloc Research BACKGROUND: Although effective treatments are available to address the cognitive deficits experienced by individuals with first-episode psychosis, provision of such treatments within Coordinated Specialty Care (CSC) programs is rare. One factor that may contribute to this is uncertainty about the cost implications of providing cognitive-enhancing treatments within the American mental healthcare system. The aim of this study is to complete a naturalistic evaluation of the cost utility of incorporating two different cognitive-enhancing interventions within an American CSC program. METHODS: Participants included 66, predominately white (75.38%), individuals with first-episode psychosis (19 women and 47 men) with a mean age of 22.71 years. Quality adjusted life years (QALYs) and cost of care were tracked among these individuals during their participation in a CSC program. These data were compared among three groups of participants during their first six months of care: (i) individuals who participated in metacognitive remediation therapy (MCR), (ii) individuals who participated in computerized cognitive remediation (CCR), and (iii) individuals who participated in no cognitive-enhancing intervention. RESULTS: Participation in MCR, but not CCR, was associated with larger gains in QALYs than participation in no cognitive-enhancing intervention within a CSC program. Moreover, data support the cost utility of MCR as compared to CCR or no-cognitive enhancing intervention within a CSC program. Conversely, CCR did not appear to be a cost-effective addition to CSC services. CONCLUSIONS: Our results highlight the potential cost utility of incorporating MCR within CSC programs for individuals with first-episode psychosis. However, given study limitations, these results should be interpreted cautiously until replicated by large, randomized controlled trials. Trial Registration ClinicalTrials.gov Identifier NCT01570972, registered April 4, 2012, Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01570972?term=breitborde&draw=2&rank=6. BioMed Central 2021-07-01 /pmc/articles/PMC8247178/ /pubmed/34210341 http://dx.doi.org/10.1186/s12962-021-00292-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Breitborde, Nicholas J. K. Bell, Emily K. Woolverton, Cindy Pine, Jacob G. Waslter, Heather Moe, Aubrey M. Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation |
title | Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation |
title_full | Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation |
title_fullStr | Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation |
title_full_unstemmed | Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation |
title_short | Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation |
title_sort | cost utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247178/ https://www.ncbi.nlm.nih.gov/pubmed/34210341 http://dx.doi.org/10.1186/s12962-021-00292-6 |
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