Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults
Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of int...
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| Veröffentlicht in: | PloS one 2020, Vol.15 (4), p.e0232245-e0232245 |
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| creator | Mavranezouli, Ifigeneia Megnin-Viggars, Odette Grey, Nick Bhutani, Gita Leach, Jonathan Daly, Caitlin Dias, Sofia Welton, Nicky J Katona, Cornelius El-Leithy, Sharif Greenberg, Neil Stockton, Sarah Pilling, Stephen |
| description | Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of interventions for adults with PTSD.
A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.
Eye movement desensitisation and reprocessing (EMDR) appeared to be the most cost-effective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self-help without support, non-TF-CBT and combined TF-CBT/SSRIs. Counselling appeared to be less cost-effective than no treatment. TF-CBT had the largest evidence base.
A number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective amongst them. TF-CBT has the largest evidence base. There remains a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of treatments for adults with PTSD. |
| doi_str_mv | 10.1371/journal.pone.0232245 |
| format | Article |
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A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.
Eye movement desensitisation and reprocessing (EMDR) appeared to be the most cost-effective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self-help without support, non-TF-CBT and combined TF-CBT/SSRIs. Counselling appeared to be less cost-effective than no treatment. TF-CBT had the largest evidence base.
A number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective amongst them. TF-CBT has the largest evidence base. There remains a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of treatments for adults with PTSD.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0232245</identifier><identifier>PMID: 32353011</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Adults ; Age ; Cognitive ability ; Cognitive behavioral therapy ; Cognitive Behavioral Therapy - methods ; Cognitive therapy ; Cost analysis ; Cost-Benefit Analysis ; Counseling ; Decision analysis ; Desensitization ; Economic models ; England ; Eye Movement Desensitization Reprocessing - methods ; Eye movements ; Female ; Gynecology ; Health psychology ; Health sciences ; Humans ; Male ; Mathematical models ; Medicine and Health Sciences ; Mental disorders ; People and Places ; Physical Sciences ; Population ; Post traumatic stress disorder ; Posttraumatic stress disorder ; Psychological stress ; Psychotherapy ; Psychotherapy - methods ; Quality-Adjusted Life Years ; Reprocessing ; Self help ; Serotonin ; Serotonin uptake inhibitors ; Serotonin Uptake Inhibitors - therapeutic use ; Social Sciences ; Social services ; State Medicine ; Stress Disorders, Post-Traumatic - drug therapy ; Stress Disorders, Post-Traumatic - psychology ; Trauma</subject><ispartof>PloS one, 2020, Vol.15 (4), p.e0232245-e0232245</ispartof><rights>2020 Mavranezouli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Mavranezouli et al 2020 Mavranezouli et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c559t-53d21440df8544c5c7b778eacb9742d9bc7c5b8efe5ec56c0df2b921946cc91c3</citedby><cites>FETCH-LOGICAL-c559t-53d21440df8544c5c7b778eacb9742d9bc7c5b8efe5ec56c0df2b921946cc91c3</cites><orcidid>0000-0001-9095-3566 ; 0000-0002-2172-0221 ; 0000-0003-4550-2971</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192458/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192458/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,4010,23845,27900,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32353011$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mavranezouli, Ifigeneia</creatorcontrib><creatorcontrib>Megnin-Viggars, Odette</creatorcontrib><creatorcontrib>Grey, Nick</creatorcontrib><creatorcontrib>Bhutani, Gita</creatorcontrib><creatorcontrib>Leach, Jonathan</creatorcontrib><creatorcontrib>Daly, Caitlin</creatorcontrib><creatorcontrib>Dias, Sofia</creatorcontrib><creatorcontrib>Welton, Nicky J</creatorcontrib><creatorcontrib>Katona, Cornelius</creatorcontrib><creatorcontrib>El-Leithy, Sharif</creatorcontrib><creatorcontrib>Greenberg, Neil</creatorcontrib><creatorcontrib>Stockton, Sarah</creatorcontrib><creatorcontrib>Pilling, Stephen</creatorcontrib><title>Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of interventions for adults with PTSD.
A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.
Eye movement desensitisation and reprocessing (EMDR) appeared to be the most cost-effective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self-help without support, non-TF-CBT and combined TF-CBT/SSRIs. Counselling appeared to be less cost-effective than no treatment. TF-CBT had the largest evidence base.
A number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective amongst them. TF-CBT has the largest evidence base. There remains a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of treatments for adults with PTSD.</description><subject>Adult</subject><subject>Adults</subject><subject>Age</subject><subject>Cognitive ability</subject><subject>Cognitive behavioral therapy</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Cognitive therapy</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>Counseling</subject><subject>Decision analysis</subject><subject>Desensitization</subject><subject>Economic models</subject><subject>England</subject><subject>Eye Movement Desensitization Reprocessing - methods</subject><subject>Eye movements</subject><subject>Female</subject><subject>Gynecology</subject><subject>Health psychology</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>People and Places</subject><subject>Physical Sciences</subject><subject>Population</subject><subject>Post traumatic stress disorder</subject><subject>Posttraumatic stress disorder</subject><subject>Psychological stress</subject><subject>Psychotherapy</subject><subject>Psychotherapy - 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Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of interventions for adults with PTSD.
A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.
Eye movement desensitisation and reprocessing (EMDR) appeared to be the most cost-effective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self-help without support, non-TF-CBT and combined TF-CBT/SSRIs. Counselling appeared to be less cost-effective than no treatment. TF-CBT had the largest evidence base.
A number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective amongst them. TF-CBT has the largest evidence base. There remains a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of treatments for adults with PTSD.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32353011</pmid><doi>10.1371/journal.pone.0232245</doi><orcidid>https://orcid.org/0000-0001-9095-3566</orcidid><orcidid>https://orcid.org/0000-0002-2172-0221</orcidid><orcidid>https://orcid.org/0000-0003-4550-2971</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2396928368 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Adults Age Cognitive ability Cognitive behavioral therapy Cognitive Behavioral Therapy - methods Cognitive therapy Cost analysis Cost-Benefit Analysis Counseling Decision analysis Desensitization Economic models England Eye Movement Desensitization Reprocessing - methods Eye movements Female Gynecology Health psychology Health sciences Humans Male Mathematical models Medicine and Health Sciences Mental disorders People and Places Physical Sciences Population Post traumatic stress disorder Posttraumatic stress disorder Psychological stress Psychotherapy Psychotherapy - methods Quality-Adjusted Life Years Reprocessing Self help Serotonin Serotonin uptake inhibitors Serotonin Uptake Inhibitors - therapeutic use Social Sciences Social services State Medicine Stress Disorders, Post-Traumatic - drug therapy Stress Disorders, Post-Traumatic - psychology Trauma |
| title | Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T17%3A58%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cost-effectiveness%20of%20psychological%20treatments%20for%20post-traumatic%20stress%20disorder%20in%20adults&rft.jtitle=PloS%20one&rft.au=Mavranezouli,%20Ifigeneia&rft.date=2020&rft.volume=15&rft.issue=4&rft.spage=e0232245&rft.epage=e0232245&rft.pages=e0232245-e0232245&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0232245&rft_dat=%3Cproquest_plos_%3E2397660228%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2396928368&rft_id=info:pmid/32353011&rft_doaj_id=oai_doaj_org_article_6441aa78a05a467b8528031bbf05120c&rfr_iscdi=true |