TY - JOUR
T1 - Economic evaluation of an experience sampling method intervention in depression compared with treatment as usual using data from a randomized controlled trial
AU - Simons, Claudia J. P.
AU - Drukker, Marjan
AU - Evers, Silvia
AU - van Mastrigt, Ghislaine A. P. G.
AU - Hohn, Petra
AU - Kramer, Ingrid
AU - Peeters, Frenk
AU - Delespaul, Philippe
AU - Menne-Lothmann, Claudia
AU - Hartmann, Jessica A.
AU - van Os, Jim
AU - Wichers, Marieke
PY - 2017/12/29
Y1 - 2017/12/29
N2 - Background: Experience 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.Methods: Participants 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 (sic)50,000 (based on Dutch guidelines for moderate severe to severe illnesses).Results: The economic evaluation showed that ESM-I is an optimal strategy only when willingness to pay is around (sic)3000 per unit HDRS and around (sic)40,500 per QALY. ESM-I was the least favourable treatment when willingness to pay was lower than (sic)30,000 per QALY. However, at the (sic)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.Conclusions: We may tentatively conclude that ESM-I is a cost-effective add-on intervention to pharmacotherapy in outpatients with major depression.
AB - Background: Experience 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.Methods: Participants 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 (sic)50,000 (based on Dutch guidelines for moderate severe to severe illnesses).Results: The economic evaluation showed that ESM-I is an optimal strategy only when willingness to pay is around (sic)3000 per unit HDRS and around (sic)40,500 per QALY. ESM-I was the least favourable treatment when willingness to pay was lower than (sic)30,000 per QALY. However, at the (sic)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.Conclusions: We may tentatively conclude that ESM-I is a cost-effective add-on intervention to pharmacotherapy in outpatients with major depression.
KW - Cost-effectiveness analysis
KW - Cost-utility analysis
KW - Ecological momentary assessment
KW - Experience sampling method
KW - Intervention study
KW - Psychological feedback
KW - Depressive disorder
KW - DAILY-LIFE
KW - COST-EFFECTIVENESS
KW - ANTIDEPRESSANT TREATMENT
KW - SYSTEMATIC ANALYSIS
KW - GENERAL-POPULATION
KW - GLOBAL BURDEN
KW - DISORDERS
KW - THERAPY
KW - CARE
KW - QUALITY
U2 - 10.1186/s12888-017-1577-7
DO - 10.1186/s12888-017-1577-7
M3 - Article
C2 - 29284448
SN - 1471-244X
VL - 17
JO - BMC Psychiatry
JF - BMC Psychiatry
M1 - 415
ER -