Cost-effectiveness of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial

McCrone, Paul; Knapp, Martín; Proudfoot, Judy; Ryden, Clash; Cavanagh, Kate; Shapiro, David A.; Ilson, Sophie; Gray, Jeffrey A.; Goldberg, David; Mann, Anthony; Marks, Isaac; Everitt, Barry J.; Tylee, André

doi:10.1192/bjp.185.1.55

Cited by 304 publications

(271 citation statements)

References 17 publications

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“…Fourth, cost-effectiveness of Internet interventions with minimal therapist input compares favorably with face-to-face interventions (Crone et al, 2004;Klein, Richards, & Austin, 2006;Mihalopoulos et al, 2005). Finally, Internet therapies offer accessible, convenient therapy for those who may be unable to access therapy, for example due to geographical location, time or childcare constrains, or those unwilling to access therapy due to pride, fear of stigma, or desire to improve with minimal assistance.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of Internet-based therapy for the treatment of addictions

Gainsbury

Blaszczynski

2011

Clinical Psychology Review

170

135

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Section: Introductionmentioning

confidence: 99%

A systematic review of Internet-based therapy for the treatment of addictions

Gainsbury

Blaszczynski

2011

Clinical Psychology Review

170

135

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“…In the treatment of depression and anxiety disorders, computer-assisted delivery of CBT has been demonstrated in randomized trials to be both effective (18)(19)(20)(21)(22)(23)(24)(25) and cost effective (26). However, there have been few evaluations of computer-assisted treatment, of any type, for the addictions.…”

Section: Introductionmentioning

confidence: 99%

Computer-Assisted Delivery of Cognitive-Behavioral Therapy for Addiction: A Randomized Trial of CBT4CBT

Carroll

Ball

Martino

et al. 2008

AJP

368

333

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Objectives-To evaluate the efficacy of a computer-based version of cognitive behavioral therapy (CBT) for substance dependence.Methods-This was a randomized clinical trial in which 77 individuals seeking treatment for substance dependence at an outpatient community setting were randomized to standard treatment or standard treatment with biweekly access to computer-based training in CBT (CBT4CBT).Results-Treatment retention and data availability were comparable across the treatment conditions. Participants assigned to the CBT4CBT condition submitted significantly more urine specimens that were negative for any type of drugs and tended to have longer continuous periods of abstinence during treatment. The CBT4CBT program was positively evaluated by participants. In the CBT4CBT condition, outcome was more strongly associated with treatment engagement than in TAU; further, completion of homework assignments in CBT4CBT was significantly correlated with outcome and a significant predictor of treatment involvement.Conclusions-These data suggest that CBT4CBT is an effective adjunct to standard outpatient treatment for substance dependence and may provide an important means of making CBT, an empirically validated treatment, more broadly available.

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“…A different approach was taken in an evaluation of computerised cognitive behavioural therapy (McCrone et Epidemiologia e Psichiatria Sociale, 16, 4, 2007al., 2004. As originally designed, the trial used the Beck Depression Inventory as the primary outcome, and also collected data using the Beck Anxiety Inventory and the Work and Social Adjustment Scale.…”

Section: Using Qalys In Mental Health Researchmentioning

confidence: 99%

“The trouble with QALYs…”

Knapp¹,

Mangalore²

2007

Epidemiol Psychiatr Sci

Self Cite

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Abstract. This paper summarises the use of QALYs in evaluating changes in mental health states, highlighting the benefits and challenges of their use in this field. The general principles underlying the QALY measure and the most common methods of measuring QALYs are discussed briefly. Evidence of the usefulness and problems of using this generic measure of health-related quality of life are provided from a sample of recent studies relating to depression, schizophrenia, attention deficit hyperactivity disorder and dementia. In each case, attempts were made to use QALYs to measure changes in health states. While in principle, the QALY is enormously attractive, its suitability for measuring changes in many mental health conditions remains open to doubt as existing tools for generating QALY scores such as the EQ-5D have tended not to perform sufficiently well in reflecting changes in many mental health states. New developmental work is needed to construct better QALY-measuring tools for use in the mental health field. Both the conceptualisation and measurement of QALYs need to be built on a valid, comprehensive model of quality of life specific to a mental health disorder, to ensure that the resultant tool is sensitive enough to pick up changes that would be expected and seen as relevant in the course of the illness. CHOOSING BETWEEN ALTERNATIVESObviously, the main aims of a mental health system are to alleviate symptoms and improve quality of life, but it is widely appreciated that regard must also be paid to the economic consequences of the treatments and support arrangements that are offered. One consequence has been the growing attention paid to the cost-effectiveness as well as the effectiveness of health care interventions. The underlying reason is scarcity: there are insufficient resources to meet all of a society's needs or demands, and so difficult choices have to be made between competing uses of those resources. In particular, decision makers with responsibility for allocating resources must weigh up the outcomes achieved in those various different uses of resources and the costs of achieving them. This is quite a challenge when the outcomes are measured in different ways. How, for example, is a decision maker to compare cancer treatment with a psychological intervention for depression or a health promotion campaign to reduce coronary heart disease? HEALTH ECONOMIC EVALUATIONS -BROADENING OUTWhen a new treatment is developed or introduced decision makers face two central questions. The clinical question is whether the intervention (say a new antidepressant) is more effective than existing interventions in alleviating depressive symptoms and generally improving health and quality of life. If the answer to the clinical question is that the new medication is no better than existing options, then there is usually no need to consider its use any further. But if it looks clinically effective, the decision maker will then want an answer to a second question: is it cost-effective? That is, does the treatment ach...

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Cost-effectiveness of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial

Abstract: Computer-delivered CBT has a high probability of being cost-effective, even if a modest value is placed on unit improvements in depression.

Cited by 304 publications

References 17 publications

A systematic review of Internet-based therapy for the treatment of addictions

A systematic review of Internet-based therapy for the treatment of addictions

Computer-Assisted Delivery of Cognitive-Behavioral Therapy for Addiction: A Randomized Trial of CBT4CBT

“The trouble with QALYs…”

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