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Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia

The Positive Memory Training (PoMeT) trial demonstrated reduced depression symptoms at 3 months for schizophrenia, but its longer-term outcome and cost impacts remain unknown. This study is a within-trial cost-utility analysis with quality-adjusted life years (QALYs) as outcome based on health-relat...

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Autores principales: Simon, Judit, Kiss, Noemi, Korrelboom, Kees, Kingdon, David, Wykes, Til, Phiri, Peter, van der Gaag, Mark, Baksh, M. Fazil, Steel, Craig
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565889/
https://www.ncbi.nlm.nih.gov/pubmed/36231292
http://dx.doi.org/10.3390/ijerph191911985
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author Simon, Judit
Kiss, Noemi
Korrelboom, Kees
Kingdon, David
Wykes, Til
Phiri, Peter
van der Gaag, Mark
Baksh, M. Fazil
Steel, Craig
author_facet Simon, Judit
Kiss, Noemi
Korrelboom, Kees
Kingdon, David
Wykes, Til
Phiri, Peter
van der Gaag, Mark
Baksh, M. Fazil
Steel, Craig
author_sort Simon, Judit
collection PubMed
description The Positive Memory Training (PoMeT) trial demonstrated reduced depression symptoms at 3 months for schizophrenia, but its longer-term outcome and cost impacts remain unknown. This study is a within-trial cost-utility analysis with quality-adjusted life years (QALYs) as outcome based on health-related quality of life (HRQoL) measurement and secondary outcome analyses of capability well-being. The incremental cost-effectiveness of PoMeT was compared to Treatment As Usual only (TAU) over 9 months from the ‘health and social’ care and ‘societal’ perspectives. Uncertainty was explored using bootstrapping and sensitivity analyses for cost outliers and outcome methods. HRQoL improvement was observed for both PoMeT and TAU at 3 months, but reached statistical significance and was sustained only for TAU. There was no change in capability well-being and no significant group difference in QALYs gained over 9 months. Mean intervention cost was GBP 823. Compared to TAU, PoMeT had significantly higher mental health care costs (+GBP 1251, 95% CI GBP 185 to GBP 2316) during the trial, but ‘health and social care’ and ‘societal’ cost differences were non-significant. Compared to the before-trial period, psychiatric medication costs increased significantly in both groups. The probability of PoMeT being cost-effective in the given format over 9 months was <30% and decreased further in sensitivity analyses.. Generalizability remains limited since the before-after cost analysis revealed additional treatment effects also in the TAU group that likely diminished the incremental impacts and cost-effectiveness of PoMeT. It is not clear whether an active post-intervention follow-up could result in sustained longer-term effects and improved cost-effectiveness.
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spelling pubmed-95658892022-10-15 Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia Simon, Judit Kiss, Noemi Korrelboom, Kees Kingdon, David Wykes, Til Phiri, Peter van der Gaag, Mark Baksh, M. Fazil Steel, Craig Int J Environ Res Public Health Article The Positive Memory Training (PoMeT) trial demonstrated reduced depression symptoms at 3 months for schizophrenia, but its longer-term outcome and cost impacts remain unknown. This study is a within-trial cost-utility analysis with quality-adjusted life years (QALYs) as outcome based on health-related quality of life (HRQoL) measurement and secondary outcome analyses of capability well-being. The incremental cost-effectiveness of PoMeT was compared to Treatment As Usual only (TAU) over 9 months from the ‘health and social’ care and ‘societal’ perspectives. Uncertainty was explored using bootstrapping and sensitivity analyses for cost outliers and outcome methods. HRQoL improvement was observed for both PoMeT and TAU at 3 months, but reached statistical significance and was sustained only for TAU. There was no change in capability well-being and no significant group difference in QALYs gained over 9 months. Mean intervention cost was GBP 823. Compared to TAU, PoMeT had significantly higher mental health care costs (+GBP 1251, 95% CI GBP 185 to GBP 2316) during the trial, but ‘health and social care’ and ‘societal’ cost differences were non-significant. Compared to the before-trial period, psychiatric medication costs increased significantly in both groups. The probability of PoMeT being cost-effective in the given format over 9 months was <30% and decreased further in sensitivity analyses.. Generalizability remains limited since the before-after cost analysis revealed additional treatment effects also in the TAU group that likely diminished the incremental impacts and cost-effectiveness of PoMeT. It is not clear whether an active post-intervention follow-up could result in sustained longer-term effects and improved cost-effectiveness. MDPI 2022-09-22 /pmc/articles/PMC9565889/ /pubmed/36231292 http://dx.doi.org/10.3390/ijerph191911985 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Simon, Judit
Kiss, Noemi
Korrelboom, Kees
Kingdon, David
Wykes, Til
Phiri, Peter
van der Gaag, Mark
Baksh, M. Fazil
Steel, Craig
Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia
title Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia
title_full Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia
title_fullStr Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia
title_full_unstemmed Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia
title_short Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia
title_sort cost-effectiveness of positive memory training (pomet) for the treatment of depression in schizophrenia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565889/
https://www.ncbi.nlm.nih.gov/pubmed/36231292
http://dx.doi.org/10.3390/ijerph191911985
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