Cost-Utility of Group Acceptance and Commitment Therapy for Fibromyalgia Versus Recommended Drugs: An Economic Analysis Alongside a 6-Month Randomized Controlled Trial Conducted in Spain (EFFIGACT Study)

Luciano, Juan V.; D’Amico, Francesco; Feliu‐Soler, Albert; McCracken, Lance M.; Aguado, Jaume; Peñarrubia-María, Maria Teresa; Knapp, Martín; Serrano‐Blanco, Antoni; Garcı́a-Campayo, Javier

doi:10.1016/j.jpain.2017.03.001

Cited by 38 publications

(57 citation statements)

References 30 publications

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“…The 22 potentially relevant studies were retrieved, and their full text was assessed for eligibility. Consideration of these studies against the selection criteria led to the exclusion of a further 11 references (Bota, Hazen, Tieu, & Novac, ; Fjorback et al ., , ; Holmes et al ., ; Lengacher et al ., ; Luciano et al ., ; McDaid & Park, ; Murphy & Bourke, ; Pots et al ., ; Prioli et al ., ; Van Roijen, Sinnaeve, Bouwmans, & Van Den Bosch, ). The remaining 10 studies presented in 11 articles formed the final set of reviewed evidence (Amner, ; Finnes et al ., ; Knight, Bean, Wilton, & Lin, ; Kuyken, et al ., ; Kuyken, et al ., 2015a,b; Pasieczny & Connor, ; Priebe et al ., ; Shawyer, Enticott, Ozmen, Inder, & Meadows, ; van Ravesteijn et al ., ; Wagner et al ., ).…”

Section: Resultsmentioning

confidence: 99%

Are acceptance and mindfulness‐based interventions ‘value for money’? Evidence from a systematic literature review

Duarte

Lloyd

Kotas

et al. 2018

British J Clinic Psychol

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Objectives Acceptance and mindfulness‐based interventions (A/ MBI s) are recommended for people with mental health conditions. Although there is a growing evidence base supporting the effectiveness of different A/ MBI s for mental health conditions, the economic case for these interventions has not been fully explored. The aim of this systematic review was to identify and appraise all available economic evidence of A/ MBI s for the management of mental health conditions. Methods Eight electronic bibliographic databases ( MEDLINE , MEDLINE In‐Process & Other Non‐Indexed Citations, EMBASE , Web of Science, NHS Economic Evaluation Database ( EED ), Database of Abstracts of Reviews of Effects ( DARE ), Health Technology Assessment ( HTA ) database, and EconLit) were searched for relevant economic evaluations published from each database's inception date until November 2017. Study selection, quality assessment, and data extraction were carried out according to published guidelines. Results Ten relevant economic evaluations presented in 11 papers were identified. Seven of the included studies were full economic evaluations (i.e., costs and effects assessed), and three studies were partial economic evaluations (i.e., only costs were considered in the analysis). The A/ MBI s that had been subjected to economic evaluation were acceptance and commitment therapy ( ACT ), dialectical behaviour therapy ( DBT ), mindfulness‐based cognitive therapy ( MBCT ), and mindfulness‐based stress reduction ( MBSR ). In terms of clinical presentations, the evaluation of cost‐effectiveness of A/ MBI s has been more focused on depression and emotional unstable personality disorder with three and four economic evaluations, respectively. Three out of seven full economic evaluations observed that A/ MBI s were cost‐effective for the management of mental health conditions. Nevertheless, the heterogeneity of included populations, interventions, and economic evaluation study types limits the extent to which firm conclusions can currently be made. Conclusion This first substantive review of economic evaluations of A/ MBI s indicates that more research is needed before firm conclusions can be reached on the cost‐effectiveness of A/ MBI s for mental health conditions. Practitioner points The findings of the review provide information that may be relevant to mental health service commissioners and decision‐make...

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Section: Resultsmentioning

confidence: 99%

Are acceptance and mindfulness‐based interventions ‘value for money’? Evidence from a systematic literature review

Duarte

Lloyd

Kotas

et al. 2018

British J Clinic Psychol

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“…Only one of the included RCTs analysed the cost-effectiveness of ACT and found that ACT was no more cost-effective than applied relaxation in the long term (Kemani et al, 2015). The authors of one included RCT published a followup study of the cost-effectiveness of ACT compared with medication or a waiting list control condition for people with FM and found ACT had fewer costs than both control conditions over the 6-month study period (Luciano et al, 2017), but long-term costeffectiveness was not evaluated. ACT treatment is likely to be expensive: in six of the reviewed RCTs, ACT was delivered by a clinical psychologist over the course of 8 to 12 weeks, the costs of which may be prohibitive in some rheumatology departments.…”

Section: Discussionmentioning

confidence: 99%

Acceptance and commitment therapy for people with rheumatic disease: Existing evidence and future directions

Hegarty

Fletcher

Conner

et al. 2020

Musculoskeletal Care

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Introduction Despite advances in the management of rheumatic diseases, many patients experience persistent pain and fatigue. Psychological interventions are useful adjunctive treatments, but improvements tend to be small, and progress in this area is needed. The aim of this review was to evaluate the effectiveness of acceptance and commitment therapy (ACT) for the treatment of chronic pain and fatigue in patients with rheumatic disease. Methods A systematic literature search was conducted in MEDLINE, EMBASE, and PsycINFO for randomised controlled trials (RCTs) of ACT for the treatment of chronic pain and fatigue in patients with rheumatic disease. Ten RCTs that included people with rheumatic disease were identified, rated for risk of bias, and summarised in terms of effects on relevant outcomes (disability, emotional functioning, pain, and quality of life). Results Treatment with ACT was associated with improvements in physical and emotional functioning, pain, and quality of life in chronic pain patients. The favourable effects of ACT were evident when compared with those of treatment as usual or active control conditions (e.g., pain education and novel medication). There was consistent evidence to show that ACT is beneficial in improving physical and emotional functioning in patients with fibromyalgia but a lack of evidence pertaining to patients with other forms of rheumatic disease. Conclusion ACT provides benefit for fibromyalgia patients. Further high‐quality research is needed to develop ACT interventions for people with inflammatory rheumatic diseases and to evaluate their effectiveness for managing the pain and fatigue associated with these conditions.

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“…Incremental cost-effectiveness ratios indicated that ACT was more cost-effective than applied relaxation after treatment and 3 months follow-up, but these findings did not remain significant at 6 months follow-up. More recently, Luciano et al 46 tested the cost–utility of group ACT and found that eight 2.5 hour sessions were cost-effective for Spanish patients with fibromyalgia recruited in primary care centers compared with recommended pharmacological treatment (pregabalin plus duloxetine in cases of comorbid major depression), regardless of the type of analysis performed or the economic perspective (health-care system or societal). Therefore, in comparison to active psychological treatments (applied relaxation) and recommended medications, there are promising cost-effectiveness results for ACT in chronic pain patients.…”

Section: Emerging Evidence About the Cost-effectiveness Of Act For Chmentioning

confidence: 99%

Current status of acceptance and commitment therapy for chronic pain: a narrative review

Feliu‐Soler¹,

Montesinos²,

Gutiérrez-Martínez³

et al. 2018

JPR

Self Cite

126

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It is well known that chronic pain is prevalent, complex to manage, and associated with high costs, in health care and society in general. Thanks to advances in new forms of cognitive behavioral therapy (known as third-wave CBT), currently clinicians and researchers have an empirically validated psychological treatment with increasing research support for the treatment of chronic pain. This treatment is called acceptance and commitment therapy (ACT). The main aim of this paper is to provide a narrative review that summarizes and integrates the current state of knowledge of ACT in the management of chronic pain as well as discuss current challenges and opportunities for progress. Based on the psychological flexibility model, ACT extends previous forms of CBT and integrates many CBT-related variables into six core therapeutic processes. ACT is a process-based therapy that fosters openness, awareness, and engagement through a wide range of methods, including exposure-based and experiential methods, metaphors, and values clarification. To our knowledge, there are three published systematic reviews and meta-analyses that support the effectiveness of ACT for chronic pain and many studies focused on specific processes derived from the psychological flexibility model. There is also promising support for the cost-effectiveness of ACT; however, the current evidence is still insufficient to establish firm conclusions about cost-effectiveness and the most efficient means of delivery. Additional well-designed economic evaluations are needed. Other research aims include delineating the neurobiological underpinnings of ACT, refining available outcome and process measures or develop new ones for ACT trials, and meeting the challenge of wide dissemination and implementation in real-world clinical practice.

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Cost-Utility of Group Acceptance and Commitment Therapy for Fibromyalgia Versus Recommended Drugs: An Economic Analysis Alongside a 6-Month Randomized Controlled Trial Conducted in Spain (EFFIGACT Study)

Cited by 38 publications

References 30 publications

Are acceptance and mindfulness‐based interventions ‘value for money’? Evidence from a systematic literature review

Are acceptance and mindfulness‐based interventions ‘value for money’? Evidence from a systematic literature review

Acceptance and commitment therapy for people with rheumatic disease: Existing evidence and future directions

Current status of acceptance and commitment therapy for chronic pain: a narrative review

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