Wednesday, 17 July 2013

Trial on psychological interventions shows it is cost-effective

Psychotherapy is cost effective in MSers with depression and anxiety. #MSBlog #MSResearch

Epub: Humphreys et al. Cost-effectiveness of an adjustment group for people with multiple sclerosis and low mood: a randomized trial. Clin Rehabil. 2013 Jul.

Objective: To evaluate the cost effectiveness of a psychological adjustment group shown to be clinically effective in comparison with usual care for MSers.

Design: Randomized controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. 

Participants: MSers were screened on the General Health Questionnaire 12 and Hospital Anxiety and Depression Scale, and those with low mood were recruited.

Interventions: Participants randomly allocated to the adjustment group received six group treatment sessions. The control group received usual care, which did not include psychological interventions.

Main measures: Outcomes were assessed four and eight months after randomization, blind to group allocation. The costs were assessed from a service use questionnaire and information provided on medication. Quality of life was assessed using the EQ-5D.

Results: Of the 311 MSers identified, 221 (71%) met the criteria for having low mood. Of these, 72 were randomly allocated to receive treatment and 79 to usual care. Over eight months follow-up there was a decrease in the combined average costs of £378 per intervention respondent and an increase in the costs of £297 per MSer in the control group, which was a significant difference (p=0.03). The incremental cost-effectiveness ratio indicated that the cost per point reduction on the Beck depression inventory-II was £118.

Conclusion: In the short term, the adjustment group programme was cost effective when compared with usual care, for MSers presenting with low mood.


"This study shows that psychological therapy for MSers with low mood was cost-effective. Does this mean that it should be offered to all people? Some would argue it easier and more effective to prescribe an antidepressant and reserve psychological therapy for pharmacological non-responders. I would suggest horses for courses; psychotherapy is not for all comers, similarly not everyone wants to take anti-depressants. What is your take on this? Anyone want to share personal experiences?"

1 comment:

  1. For what it's worth, the most helpful psychological intervention I had was being in your clinic and hearing (..really hearing) what you had to say. It was the turning point and spurred me on to go for counselling and antidepressants and to start taking back control of my life. Prior to coming to your clinic I had been seen locally by a neuro whose words/attitude were so destructive that I went into a tailspin. To this day I am convinced it was that experience which brought on a major relapse 48 hours later (fortunately nothing major since then thanks to good care,). All psychological inputs are, in my book, secondary to the importance of a good clinical team. So, ten years on, my thanks again. (And THANK GOODNESS to the GP who referred me!)

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