Guided Internet-Based Cognitive Behavioral Therapy for Insomnia: Health-Economic Evaluation From the Societal and Public Health Care Perspective Alongside a Randomized Controlled Trial.
Background: The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I's health-economic effects.Objective: This study aimed to evaluate the cost-effectiveness and cost-utility of iCBT-I in reducing insomnia among schoolteac...
| Publicado en: | Journal of Medical Internet Research Vol. 23; no. 5 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
JMIR Publications Inc.
May2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=150667256&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150667256 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14394456 DNC jtl: Journal of Medical Internet Research issn: 14394456 maglogo: N pubinfo: dt: May2021 vid: 23 iid: 5 pid: 21567 pub: JMIR Publications Inc. place: Toronto, Ontario artinfo: ui: 150667256 150667256 NLM34028361 150667256 10.2196/25609 NLM34028361 150667256 ppct: 1 formats: tig: atl: Guided Internet-Based Cognitive Behavioral Therapy for Insomnia: Health-Economic Evaluation From the Societal and Public Health Care Perspective Alongside a Randomized Controlled Trial. aug: au: Buntrock, Claudia Lehr, Dirk Smit, Filip Horvath, Hanne Berking, Matthias Spiegelhalder, Kai Riper, Heleen Ebert, David Daniel affil: Chair of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany sug: subj: Insomnia Therapy Human Cost Benefit Analysis Public Health Quality-Adjusted Life Years Internet Treatment Outcomes Randomized Controlled Trials Random Assignment ab: Background: The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I's health-economic effects.Objective: This study aimed to evaluate the cost-effectiveness and cost-utility of iCBT-I in reducing insomnia among schoolteachers.Methods: Schoolteachers (N=128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a wait list control group, both with unrestricted access to treatment as usual. Health care use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and a public health care perspective. Costs were related to symptom-free status (score <8 on the insomnia severity index) and quality-adjusted life years (QALYs) gained. Sampling error was handled using nonparametric bootstrapping.Results: Statistically significant differences favoring the intervention group were found for both health outcomes (symptom-free status yes or no: β=.30; 95% CI 0.16-0.43; QALYs: β=.019, 95% CI 0.01-0.03). From a societal perspective, iCBT-I had a 94% probability of dominating the wait list control for both health outcomes. From a public health care perspective, iCBT-I was more effective but also more expensive than the wait list control, resulting in an incremental cost-effectiveness ratio of €650 per symptom-free individual. In terms of QALYs, the incremental cost-effectiveness ratio was €11,285. At a willingness-to-pay threshold of €20,000 per QALY gained, the intervention's probability of being cost-effective was 89%.Conclusions: Our trial indicates that iCBT could be considered as a good value-for-money intervention for insomnia.Trial Registration: German Clinical Trial Registry: DRKS00004700; https://tinyurl.com/2nnk57jm.International Registered Report Identifier (irrid): RR2-10.1186/1745-6215-14-169. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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