Long-term effectiveness and cost-effectiveness of guided internet-based cognitive behavioral therapy for obsessive-compulsive disorder: 24-month follow-up

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Pub Date : 2024-02-08 DOI:10.1016/j.invent.2024.100725

Kazuki Matsumoto , Sayo Hamatani , Eiji Shimizu

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Abstract

This study investigated the long-term effectiveness and cost-effectiveness of guided internet-based cognitive behavioral therapy (ICBT) for obsessive-compulsive disorder (OCD). Twenty-five patients with OCD who had undergone guided ICBT in a randomized controlled trial or a single-arm trial were followed up for 6, 12, and 24 months. Missing data were imputed using the mice package in R, and a one-way analysis of variance with repeated measures was performed. The total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score significantly decreased from baseline to all endpoints (p < 0.001). OCD remission (the total Y-BOCS score < 14) rates significantly increased from post-treatment (48 %) at the 12 months (80 %) and 24 months (76 %) follow-up (χ2 (1) = 7.11–11.08, p < 0.01) post guided ICBT. Regression analysis predicted the maintenance of remission at 12 and 24 months following post-treatment remission (z = 2.20, p = 0.03). An incremental cost-effectiveness ratio was calculated to assess the cost-effectiveness of guided ICBT. The incremental cost-effectiveness ratio was JPY 999,495, below the JPY 5 million threshold for willingness to pay in Japan. Our findings demonstrate the long-term effectiveness and cost-effectiveness of guided ICBT for OCD. Guided ICBT can mitigate the severity of OCD even after treatment.

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基于互联网的认知行为疗法治疗强迫症的长期有效性和成本效益：24 个月随访

本研究调查了基于互联网的认知行为指导疗法（ICBT）治疗强迫症（OCD）的长期有效性和成本效益。研究人员对在随机对照试验或单臂试验中接受过引导式认知行为疗法的 25 名强迫症患者进行了 6、12 和 24 个月的随访。使用 R 中的 mice 软件包对缺失数据进行了估算，并进行了重复测量的单因子方差分析。耶鲁-布朗强迫症量表（Y-BOCS）总分从基线到所有终点均显著下降（p <0.001）。强迫症缓解率（Y-BOCS 总分< 14）在 ICBT 指导后的 12 个月（80%）和 24 个月（76%）随访中（χ2 (1) = 7.11-11.08, p <0.01）比治疗后（48%）明显增加。回归分析预测了治疗后 12 个月和 24 个月的缓解率（z = 2.20，p = 0.03）。我们计算了增量成本效益比，以评估引导式 ICBT 的成本效益。增量成本效益比为 999,495 日元，低于日本 500 万日元的支付意愿门槛。我们的研究结果表明，对强迫症进行有指导的 ICBT 治疗具有长期有效性和成本效益。即使在治疗后，指导性综合心理治疗仍可减轻强迫症的严重程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Medicine-Health Informatics

CiteScore

6.50

自引率

9.30%

发文量

审稿时长

6 weeks

期刊介绍： Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions