van Vliet Noortje I, Stant A Dennis, Huntjens Rafaele, van Dijk Maarten K, de Jongh Ad
Dimence Mental Health Group, Deventer, Netherlands.
Zovon, Enschede, Netherlands.
Front Psychol. 2024 Jun 21;15:1310372. doi: 10.3389/fpsyg.2024.1310372. eCollection 2024.
Policymakers, health insurers, and health care providers are becoming increasingly interested in cost-effectiveness analyses (CEA's) when choosing between possible treatment alternatives, as costs for mental health care have been increasing in recent years.
The current study compared the cost-effectiveness and cost-utility of a phased-based treatment approach that included a preparatory stabilization phase with direct trauma-focused treatment in patients with PTSD and a history of childhood abuse.
A cost-effectiveness analysis was conducted based on data from a randomized controlled trial of 121 patients with PTSD due to childhood abuse. A phase-based treatment (Eye Movement Desensitization and Reprocessing [EMDR] therapy preceded by Skills Training in Affect and Interpersonal Regulation [STAIR]; = 57) was compared with a direct trauma-focused treatment (EMDR therapy only; = 64). The primary outcome of cost-effectiveness was the proportion of patients with remitted PTSD. Quality-adjusted life years (QALY) were used as the primary outcome measure for cost-utility analysis.
Although the results of the cost-effectiveness analyses yielded no statistically significant differences between the two groups, the mean societal costs per patient differed significantly between the STAIR-EMDR and EMDR therapy groups (€19.599 vs. €13.501; M cost differences = €6.098, CI (95%) = [€117; €12.644]).
STAIR-EMDR is not cost-effective compared with EMDR-only therapy. Since trauma-focused treatment is less time-consuming, non-trauma-focused phase-based, treatment does not seem to be a viable alternative for the treatment of PTSD due to adverse childhood events.: https://onderzoekmetmensen.nl/nl/trial/22074, identifier NL5836.
近年来，随着精神卫生保健费用不断增加，政策制定者、健康保险公司和医疗服务提供者在选择可能的治疗方案时，对成本效益分析（CEA）的兴趣日益浓厚。
本研究比较了一种分阶段治疗方法的成本效益和成本效用，该方法包括一个准备稳定阶段，并对患有创伤后应激障碍（PTSD）且有童年虐待史的患者进行直接的创伤聚焦治疗。
基于一项针对121名因童年虐待而患有PTSD的患者的随机对照试验数据进行成本效益分析。将一种分阶段治疗（先进行情感与人际调节技能训练[STAIR]，然后进行眼动脱敏再处理[EMDR]治疗；n = 57）与一种直接的创伤聚焦治疗（仅进行EMDR治疗；n = 64）进行比较。成本效益的主要结果是PTSD缓解患者的比例。质量调整生命年（QALY）用作成本效用分析的主要结果指标。
虽然成本效益分析结果显示两组之间无统计学显著差异，但STAIR-EMDR组和EMDR治疗组之间每名患者的平均社会成本差异显著（19599欧元对13501欧元；平均成本差异 = 6098欧元，95%置信区间 = [117欧元；12644欧元]）。
与仅进行EMDR治疗相比，STAIR-EMDR不具有成本效益。由于创伤聚焦治疗耗时较少，基于非创伤聚焦的分阶段治疗似乎不是治疗因童年不良事件导致的PTSD的可行替代方案。: https://onderzoekmetmensen.nl/nl/trial/22074，标识符NL5836
