Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model.
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Authors
Papanikolaou, Nestor
McKinnon, Anna
Dalgleish, Tim
Dixon, Clare
Publication Date
2018-07Journal Title
Journal of child psychology and psychiatry, and allied disciplines
ISSN
0021-9630
Volume
59
Issue
7
Pages
773-780
Language
eng
Type
Article
This Version
VoR
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Shearer, J., Papanikolaou, N., Meiser-Stedman, R., McKinnon, A., Dalgleish, T., Smith, P., Dixon, C., & et al. (2018). Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model.. Journal of child psychology and psychiatry, and allied disciplines, 59 (7), 773-780. https://doi.org/10.1111/jcpp.12851
Abstract
BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was £2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK £20,000 to £30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated.
Keywords
Humans, Models, Econometric, Follow-Up Studies, Stress Disorders, Post-Traumatic, Quality-Adjusted Life Years, Adolescent, Child, Cost-Benefit Analysis, Female, Male, Early Medical Intervention, Cognitive Behavioral Therapy, Outcome Assessment, Health Care
Sponsorship
MRC (unknown)
Identifiers
External DOI: https://doi.org/10.1111/jcpp.12851
This record's URL: https://www.repository.cam.ac.uk/handle/1810/274841
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