1. Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: a randomized controlled trial
- Author
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Jessica Bodin, Julie Etienne, Emelie Lindkvist, Per Carlbring, Erik Hedman, Gerhard Andersson, Åsa Kadowaki, Lise Bergman Nordgren, and Stina Eriksson
- Subjects
Male ,Cost effectiveness ,Cost-Benefit Analysis ,Comorbidity ,Anxiety ,Acceptance and commitment therapy ,law.invention ,Randomized controlled trial ,law ,Psychology ,Depression (differential diagnoses) ,education.field_of_study ,Depression ,Cognition ,Health Care Costs ,Middle Aged ,anxiety ,Internet-administered cognitive behaviour therapy ,Primary care ,Anxiety Disorders ,comorbidity ,Clinical Psychology ,Psychiatry and Mental health ,Treatment Outcome ,Cognitive behavior therapy ,depression ,medicine.symptom ,Adult ,medicine.medical_specialty ,cognitive behavior therapy ,education ,Population ,Experimental and Cognitive Psychology ,Young Adult ,medicine ,Humans ,Psychiatry ,cost-effectiveness ,Aged ,Internet ,Psykologi ,Cognitive Behavioral Therapy ,Primary Health Care ,medicine.disease ,Internet-delivered cognitive behavior therapy ,Therapy, Computer-Assisted ,Quality of Life ,Patient Compliance ,Cost-effectiveness - Abstract
A significant proportion of the general population suffers from anxiety disorders, often with comorbid psychiatric conditions. Internet-delivered cognitive behavior therapy (ICBT) has been found to be a potent treatment for patients with specific psychiatric conditions. The aim of this trial was to investigate the effectiveness and cost-effectiveness of ICBT when tailoring the treatment to address comorbidities and preferences for primary-care patients with a principal anxiety disorder. One hundred participants were recruited through their primary-care contact and randomized to either treatment or an active control group. The treatment consisted of 7–10 weekly individually assigned modules guided by online therapists. At post-treatment, 46% of the treatment group had achieved clinically significant improvement on the primary outcome measure (CORE-OM) and between-group effect sizes ranged from d = 0.20 to 0.86, with a mean effect of d = 0.59. At one-year follow-up, within-group effect sizes varied between d = 0.53 to 1.00. Cost analysis showed significant reduction of total costs for the ICBT group, the results were maintained at one-year follow-up and the incremental cost-effectiveness ratio favored ICBT compared to control group. Individually tailored ICBT is an effective and cost-effective treatment for primary-care patients with anxiety disorders with or without comorbidities.Trial RegistrationClinicaltrials.gov: NCT01390168.
- Published
- 2013