Economic evaluation of an experience sampling method intervention in depression compared with treatment as usual using data from a randomized controlled trial

BMC Psychiatry

Research Article

Ghislaine A. P. G. van Mastrigt¹  Silvia Evers²  Petra Höhn³  Claudia Menne-Lothmann³  Marjan Drukker³  Frenk Peeters³  Jim van Os⁴  Claudia J. P. Simons⁵  Ingrid Kramer⁵  Philippe Delespaul⁶  Marieke Wichers⁷  Jessica A. Hartmann⁸ 

[1] Department of Health Services Research, School of Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands;Department of Health Services Research, School of Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands;Trimbos Institute, Netherlands Institute of Mental Health and Addiction Department of Public Mental Health, Utrecht, The Netherlands;Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands;Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands;Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, the Netherlands;King’s College London, King’s Health Partners Department of Psychosis Studies; Institute of Psychiatry, London, UK;Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands;GGzE, Institute for Mental Health Care Eindhoven and De Kempen, Eindhoven, The Netherlands;Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands;Mondriaan Mental Health Trust South Limburg, Heerlen, The Netherlands;Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Centre Groningen (UMCG), Groningen, The Netherlands;Orygen, the National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia;

关键词: Cost-effectiveness analysis;    Cost-utility analysis;    Ecological momentary assessment;    Experience sampling method;    Intervention study;    Psychological feedback;    Depressive disorder;   

DOI  :  10.1186/s12888-017-1577-7

 received in 2016-08-03, accepted in 2017-12-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundExperience sampling, a method for real-time self-monitoring of affective experiences, holds opportunities for person-tailored treatment. By focussing on dynamic patterns of positive affect, experience sampling method interventions (ESM-I) accommodate strategies to enhance personalized treatment of depression―at potentially low-costs. This study aimed to investigate the cost-effectiveness of an experience sampling method intervention in patients with depression, from a societal perspective.MethodsParticipants were recruited between January 2010 and February 2012 from out-patient mental health care facilities in or near the Dutch cities of Eindhoven and Maastricht, and through local advertisements. Out-patients diagnosed with major depression (n = 101) receiving pharmacotherapy were randomized into: (i) ESM-I consisting of six weeks of ESM combined with weekly feedback regarding the individual’s positive affective experiences, (ii) six weeks of ESM without feedback, or (iii) treatment as usual only. Alongside this randomised controlled trial, an economic evaluation was conducted consisting of a cost-effectiveness and a cost-utility analysis, using Hamilton Depression Rating Scale (HDRS) and quality adjusted life years (QALYs) as outcome, with willingness-to-pay threshold for a QALY set at €50,000 (based on Dutch guidelines for moderate severe to severe illnesses).ResultsThe economic evaluation showed that ESM-I is an optimal strategy only when willingness to pay is around €3000 per unit HDRS and around €40,500 per QALY. ESM-I was the least favourable treatment when willingness to pay was lower than €30,000 per QALY. However, at the €50,000 willingness-to-pay threshold, ESM-I was, with a 46% probability, the most favourable treatment (base-case analysis). Sensitivity analyses confirmed the robustness of these results.ConclusionsWe may tentatively conclude that ESM-I is a cost-effective add-on intervention to pharmacotherapy in outpatients with major depression.Trial registrationNetherlands Trial register, NTR1974.

【 授权许可】

CC BY   
© The Author(s). 2017