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Exposure-based treatments for childhood abuse-related post-traumatic stress disorder in adults: A health-economic evaluation

Authors :
Kullberg, M.L.J.
Schoorl, M.
Oprel, D.A.C.
Hoeboer, C.M.
Smit, F.
Does, A.J.W. van der
Kleine, R.A. de
Minnen, A. van
Hout, W.B. van den
Kullberg, M.L.J.
Schoorl, M.
Oprel, D.A.C.
Hoeboer, C.M.
Smit, F.
Does, A.J.W. van der
Kleine, R.A. de
Minnen, A. van
Hout, W.B. van den
Source :
European Journal of Psychotraumatology; 2000-8198; 1; 14; 2171752; ~European Journal of Psychotraumatology~~~~~2000-8198~1~14~~2171752
Publication Year :
2023

Abstract

Item does not contain fulltext<br />Background: Prolonged exposure (PE) is an effective treatment for post-traumatic stress disorder (PTSD). Objective: This study aimed to analyse the cost-effectiveness of three exposure-based treatments in patients with childhood abuse-related PTSD. Method: A net–benefit analysis was conducted alongside a pragmatic randomized controlled trial with participants (N = 149) randomized to three conditions: PE (n = 48), intensified PE (i-PE, n = 51), and phase-based PE [Skills Training in Affective and Interpersonal Regulation (STAIR) + PE, n = 50]. Assessments took place at baseline (T0), post-treatment (T3), 6 month follow-up (T4), and 12 month follow-up (T5). Costs stemming from healthcare utilization and productivity losses were estimated using the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness. Quality-adjusted life-years (QALYs) were based on the 5-level EuroQoL 5 Dimensions (EQ-5D-5L) using the Dutch tariff. Missing values of costs and utilities were multiply imputed. To compare i-PE to PE and STAIR + PE to PE, pair-wise unequal-variance t-tests were conducted. Net–benefit analysis was used to relate costs to QALYs and to draw acceptability curves. Results: Intervention costs did not differ across the three treatment conditions. Total medical costs, productivity losses, total societal costs, and EQ-5D-5L-based QALYs did not differ between treatment conditions either (all p > .10). At the relevant €50,000/QALY threshold, the probability of one treatment being more cost-effective than another was 32%, 28%, and 40% for PE, i-PE, and STAIR-PE, respectively. Conclusion: Three equally effective treatments were compared and no differences in cost-effectiveness between treatments were found. Therefore, we advocate the implementation and adoption of any of the treatments and endorse shared decision making.

Details

Database :
OAIster
Journal :
European Journal of Psychotraumatology; 2000-8198; 1; 14; 2171752; ~European Journal of Psychotraumatology~~~~~2000-8198~1~14~~2171752
Publication Type :
Electronic Resource
Accession number :
edsoai.on1371217308
Document Type :
Electronic Resource