Trial-based economic evaluation of the BrainACT study: acceptance and commitment therapy for anxiety and/or depressive symptoms after acquired brain injury.

IF 2.6 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Sander Osstyn, Johanne Rauwenhoff, Ron Handels, Marjolein E de Vugt, Silvia Evers, Ghislaine A P G van Mastrigt, Caroline M van Heugten
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引用次数: 0

Abstract

Introduction: Following acquired brain injury (ABI), individuals often experience anxiety and/or depressive symptoms. BrainACT is an adapted form of Acceptance and Commitment Therapy (ACT) tailored to this target group. The current study is a trial-based health-economic evaluation comparing BrainACT to a psychoeducation and relaxation control treatment.

Methods: An economic evaluation from a societal perspective was conducted in the Netherlands alongside a multicenter randomized controlled two-armed parallel trial including 72 participants. A cost-utility and cost-effectiveness analysis was conducted where incremental costs, quality-adjusted life-years (QALYs), and anxiety/depression (Hospital Anxiety and Depression Scale (HADS) score) were collected and presented over a 1-year follow-up period. Bootstrapping, scenario, and subgroup analyses were performed to test the robustness of the results.

Results: The BrainACT arm reported non-significant lower total costs (incremental difference of €-4,881; bootstrap interval €-12,139 to €2,330) combined with significantly decreased anxiety/depression (HADS) (3.2; bootstrap intervals 0.7-5.7). However, the total QALYs were non-significantly lower (-0.008; bootstrap interval -0.060 to 0.042) for BrainACT. The probability of the intervention being cost-effective was 86 percent at a willingness-to-accept threshold of €50,000/QALY. The scenario and subgroup analyses confirmed the robustness of the results.

Conclusion: BrainACT may be a more cost-effective alternative to a psychoeducation and relaxation intervention for anxiety and/or depressive symptoms following ABI. Despite limitations, BrainACT appears to be a promising addition to treatment options in the Netherlands. Further research is needed to validate these findings, and consideration should be given to implementing BrainACT in Dutch clinical settings with ongoing monitoring.

BrainACT研究的基于试验的经济评价:接受和承诺治疗获得性脑损伤后焦虑和/或抑郁症状
导读:在获得性脑损伤(ABI)后,个体通常会出现焦虑和/或抑郁症状。BrainACT是为这一目标群体量身定制的接受和承诺疗法(ACT)的一种改编形式。目前的研究是一项基于试验的健康经济评估,将BrainACT与心理教育和放松控制治疗进行比较。方法:在荷兰进行了一项从社会角度进行的经济评估,同时进行了一项包括72名参与者的多中心随机对照双臂平行试验。在1年的随访期间,收集了增量成本、质量调整生命年(QALYs)和焦虑/抑郁(医院焦虑和抑郁量表(HADS)评分),并进行了成本-效用和成本-效果分析。采用引导分析、情景分析和亚组分析来检验结果的稳健性。结果:BrainACT手臂报告的总成本无显著降低(增量差异为€4,881;引导间隔€12,139至€2,330),并显著降低焦虑/抑郁(HADS) (3.2;引导间隔0.7-5.7)。然而,总QALYs无显著性降低(-0.008;启动间隔-0.060至0.042)。在愿意接受阈值为50,000欧元/QALY的情况下,干预措施具有成本效益的概率为86%。情景分析和亚组分析证实了结果的稳健性。结论:对于ABI后的焦虑和/或抑郁症状,BrainACT可能是一种比心理教育和放松干预更具成本效益的替代方法。尽管有局限性,BrainACT在荷兰似乎是一种有希望的治疗选择。需要进一步的研究来验证这些发现,并应考虑在荷兰临床环境中实施BrainACT并进行持续监测。
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来源期刊
International Journal of Technology Assessment in Health Care
International Journal of Technology Assessment in Health Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.40
自引率
15.60%
发文量
116
审稿时长
6-12 weeks
期刊介绍: International Journal of Technology Assessment in Health Care serves as a forum for the wide range of health policy makers and professionals interested in the economic, social, ethical, medical and public health implications of health technology. It covers the development, evaluation, diffusion and use of health technology, as well as its impact on the organization and management of health care systems and public health. In addition to general essays and research reports, regular columns on technology assessment reports and thematic sections are published.
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