预防性认知疗法的经济评估与认知行为疗法响应者的常规护理相比
Margo de Jonge1,2, Matthijs Blankers1,3, Claudi L H Bockting4
1Department of Research, Arkin, Amsterdam, Netherlands.
Frontiers in psychiatry
|January 25, 2024
概括
预防性认知疗法 (PCT) 可能会增加经常性抑郁患者的无抑郁日数,但基于质量调整后生命年 (QALYs) 的成本效益并不高. 需要进一步的研究来确认长期的经济效益.
科学领域:
- 心理健康经济学 心理健康经济学
- 临床心理学 临床心理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 重度抑郁症 (MDD) 的复发会导致严重的残疾和医疗保健费用.
- 预防性认知疗法 (PCT) 显示出预防MDD复发的潜力.
- 本研究评估了PCT对复发性MDD患者的经济影响.
研究的目的:
- 进行PCT与经常性抑郁患者的常规护理之间的经济评估.
- 为了比较PCT与常规护理之间的与健康相关的生活质量 (QALYs) 和无抑郁症日.
- 评估社会成本,包括医疗保健利用率和生产力损失.
主要方法:
- 一个随机试验 (N=214) 具有社会视角的经济评估.
- 在15个月内测量QALY,无抑郁日,医疗保健使用和生产力.
- 成本被索引到2014年.
主要成果:
- 两组之间QALY收益没有显著差异 (p=0.69).
- 在PCT组,无抑郁日数显著增加 (p=0.02).
- 与通常的护理 (9,545欧元) 相比,PCT的社会成本更高 (10,417欧元),有72%的可能性会有更多的无抑郁日,但成本更高.
结论:
- 由于成本较高,当QALY是主要结果时,PCT不是具有成本效益的.
- 当专注于没有抑郁症的日子时,PCT显示了有利的经济前景.
- 15个月的随访可能不足以获得最终的长期成本效益结论.
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