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Clinical effectiveness, cost-effectiveness and process evaluation of group schema therapy for eating disorders: study
Suzanne H W Mares1, Jeffrey Roelofs2, Janôt Zinzen2,3
1Department of Eating Disorders (Amarum), GGNet Mental Health, St. Annastraat 312c, Nijmegen, 6525 HG, The Netherlands. s.mares@ggnet.nl.
BMC Psychology
|March 4, 2024
Summary
Group schema therapy (GST) may be more effective and cost-effective than enhanced cognitive behavioral therapy (CBT-E) for patients with eating disorders (EDs) not responding to initial CBT-E. This study will compare GST and CBT-E in a multicenter trial.
Area of Science:
- Psychiatry and Behavioral Sciences
- Health Economics
Background:
- Eating disorders (EDs) like Anorexia Nervosa (AN) and Bulimia Nervosa (BN) present significant treatment challenges and socioeconomic burdens.
- Enhanced cognitive behavioral therapy (CBT-E) is a standard treatment, but its efficacy may be limited for patients not showing rapid improvement.
- Group schema therapy (GST) shows promise for EDs, yet requires further evidence, particularly regarding cost-effectiveness.
Purpose of the Study:
- To compare the clinical effectiveness and cost-effectiveness of GST versus CBT-E for (atypical) AN and BN patients unresponsive to initial CBT-E.
- To conduct process evaluations for both GST and CBT-E to understand treatment implementation and patient experiences.
- To provide guidance for optimizing ED care trajectories based on comparative treatment outcomes.
Main Methods:
- A multicenter randomized controlled trial (RCT) involving 232 Dutch patients with (atypical) AN or BN referred for CBT-E.
- Clinical effectiveness and cost-effectiveness assessed at baseline, post-treatment, and at 6 and 12 months follow-up.
- Process evaluations including patient experiences and adherence to protocol, alongside qualitative interviews for quality of life and goal achievement.
Main Results:
- Hypothesizes GST will be superior to CBT-E in clinical and cost-effectiveness for the target patient group.
- Data analysis will employ regression-based mixed modeling, multivariate sensitivity analyses, and qualitative coding.
Conclusions:
- This is the first multicenter RCT protocol designed to compare GST and CBT-E for non-rapid responders in ED treatment.
- The study protocol outlines potential risks and aims to inform healthcare stakeholders on optimizing ED treatment pathways.
- Expected findings will contribute to evidence-based decision-making in eating disorder care.
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