计算机辅助认知行为治疗抑郁症的成本效益在初级保健中的成年人中
Shehzad Ali1,2,3, Feben W Alemu1, Jesse Owen4
1Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada.
JAMA network open
|November 14, 2024
概括
计算机辅助认知行为疗法 (CCBT) 是一种经济有效的抑郁症治疗方法,适用于各种各样的初级保健患者. 这项研究表明,CCBT改善了生活质量和治疗反应,即使对于那些收入低或互联网接入有限的人来说也是如此.
科学领域:
- 卫生经济学 卫生经济学
- 心理健康服务研究 心理健康服务研究
- 数字健康干预措施 数字健康干预措施
背景情况:
- 抑郁症影响了五分之一的成年人,但只有不到一半的人得到了专业的帮助,社会经济上处于劣势的个人之间存在差异.
- 计算机辅助认知行为疗法 (CCBT) 为抑郁症提供了一种有效且易于获得的治疗方法.
- 在各种人群中,包括那些面临社会经济挑战的人群中,CCBT的成本效益尚未得到充分证实.
研究的目的:
- 评估临床医生支持的CCBT与通常治疗 (TAU) 相比的成本效益.
- 在初级保健环境中评估CCBT,其中包括低收入个人和有限数字接入的人群.
- 确定CCBT对质量调整寿命年 (QALYs) 和治疗反应的影响.
主要方法:
- 基于随机临床试验的成本效益分析进行.
- 患有轻度至中度抑郁症的参与者接受了12周的临床医生支持或TAU的CCBT.
- 结果包括QALY (SF-12) 和治疗反应 (≥50%的PHQ改善);成本包括干预,临床医生时间和数字访问支持.
主要成果:
- 与TAU相比,临床医生支持的CCBT证明了改善生活质量和更高的治疗响应率,在治疗后和6个月的随访中.
- 对于CCBT,增量成本效益比 (ICER) 为每QALY37295美元,在50,000美元/QALY值时,成本效益的概率为89.4%.
- 每个治疗响应病例的ICER为3,623.3美元.
结论:
- 临床医生支持的CCBT是对初级保健患者,包括来自不同社会经济背景的患者的抑郁症的成本有效干预措施.
- 这些发现支持了通过数字干预来解决贫困人口的心理健康需求的政策影响.
- CCBT提供了可行的和有效的治疗选择,改善了患者的治疗结果和生活质量.
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