Cost Utility of cognition-enhancing interventions for individuals with first-episode psychosis: a naturalistic evaluation

Cost Effectiveness and Resource Allocation

Emily K. Bell¹  Aubrey M. Moe²  Heather Waslter²  Jacob G. Pine²  Nicholas J. K. Breitborde³  Cindy Woolverton⁴ 

[1] 56th Medical Group, Luke Air Force Base, Glendale, USA;Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, USA;Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, USA;Department of Psychology, The Ohio State University, Columbus, USA;Department of Psychology, University of Arizona, Tucson, USA;

关键词: Cognition;    Coordinated specialty care;    Cost utility;    First-episode psychosis;    Cognitive remediation;   

DOI  :  10.1186/s12962-021-00292-6

来源: Springer

【 摘 要 】

BackgroundAlthough effective treatments are available to address the cognitive deficitsexperienced 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.MethodsParticipants 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.ResultsParticipation 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.ConclusionsOur 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.

【 授权许可】

CC BY