Cognitive–behavioural therapy may reduce high rates of service use among frequent primary care attenders

2017 ◽  
Vol 20 (2) ◽  
pp. 52-52
Author(s):  
Christina L Goodwin ◽  
Risa B Weisberg
Keyword(s):  
Primary Care ◽  
Cognitive Behavioural Therapy ◽  
Service Use ◽  
Behavioural Therapy ◽  
Cognitive Behavioural

scholarly journals Cost-effectiveness of internet-based cognitive–behavioural therapy and physical exercise for depression

BJPsych Open ◽  
2018 ◽  
Vol 4 (4) ◽  
pp. 265-273 ◽  
Author(s):  
Martin Kraepelien ◽  
Simon Mattsson ◽  
Erik Hedman-Lagerlöf ◽  
Ingemar F. Petersson ◽  
Yvonne Forsell ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Physical Exercise ◽  
Cognitive Behavioural Therapy ◽  
Service Use ◽  
Controlled Trial ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Life Years

BackgroundBoth internet-based cognitive–behavioural therapy (ICBT) and physical exercise are alternatives to treatment as usual (TAU) in managing mild to moderate depression in primary care.AimsTo determine the cost-effectiveness of ICBT and physical exercise compared with TAU in primary care.MethodEconomic evaluation of a randomised controlled trial (N = 945) in Sweden. Costs were estimated by a service use questionnaire and used together with the effects on quality-adjusted life-years (QALYs). The primary 3-month healthcare provider perspective in primary care was complemented by a 1-year societal perspective.ResultsThe primary analysis showed that incremental cost per QALY gain was €8817 for ICBT and €14 571 for physical exercise compared with TAU. At the established willingness-to-pay threshold of €21 536 (£20 000) per QALY, the probability of ICBT being cost-effective is 90%, and for physical exercise is 76%, compared with TAU.ConclusionsFrom a primary care perspective, both ICBT and physical exercise for depression are likely to be cost-effective compared with TAU.Declaration of interestNone.

An investigation into the efficacy of a cognitive behavioural therapy group for low self-esteem in a primary care setting

2018 ◽  
Vol 11 ◽  
Author(s):  
Sarah Beattie ◽  
David Beattie
Keyword(s):  
Primary Care ◽  
Cognitive Behavioural Therapy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Therapy Group ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Mood Group ◽  
Group Programme

AbstractSelf-esteem refers to how an individual appraises themselves and is associated with good mental health. A number of studies have identified the efficacy of cognitive behavioural therapy (CBT) in the treatment of low self-esteem based on the formulation and treatment trajectory developed by Fennell (1999). However, there has been little empirical enquiry into the efficacy of the programme delivered in primary care. The current study investigated the effectiveness of a CBT programme for low self-esteem delivered within primary care. Fifty-four participants attended a 9-week ‘Boost Your Mood’ group programme. Paired sample t-tests were conducted on pre- and post-group scores on measures of depression, anxiety and self-esteem. Results indicated that there were statistically significant improvements in levels of depression, anxiety and self-esteem post-treatment. Findings are consistent with the suggestion that group CBT may be effective at increasing levels of self-esteem and reducing levels of depression and anxiety when delivered in a primary care setting.

scholarly journals Digital cognitive behavioural therapy for insomnia and primary care costs in England: an interrupted time series analysis

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0146
Author(s):  
Chris Sampson ◽  
Eleanor Bell ◽  
Amanda Cole ◽  
Christopher B Miller ◽  
Tracey Marriott ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Cognitive Behavioural Therapy ◽  
Interrupted Time Series ◽  
Behavioural Therapy ◽  
Interrupted Time Series Analysis ◽  
Cognitive Behavioural ◽  
Before And After ◽  
Quasi Experimental ◽  
Care Costs

BackgroundSleepio is an automated digital programme that delivers cognitive behavioural therapy for insomnia (dCBT-I). Sleepio has been proven effective in improving sleep difficulties. However, evidence for the possible impact of Sleepio use on health care costs in the United Kingdom has not previously been developed.AimWe sought to identify the effect of a population-wide rollout of Sleepio in terms of primary care costs in the National Health Service (NHS) in England.Design & settingThe study was conducted in the Thames Valley region of England, where access to Sleepio was made freely available to all residents between October 2018 and January 2020. The study relies on a quasi-experimental design, using an interrupted time series to compare the trend in primary care costs before and after the rollout of Sleepio.MethodWe use primary care data for people with relevant characteristics from nine general practices in Buckinghamshire. Primary care costs include general practice contacts and prescriptions. Segmented regression analysis was used to estimate primary and secondary outcomes.ResultsFor the 10,704 patients included in our sample, the total saving over the 65-week follow-up period was £71,027. This corresponds to £6.64 per person in our sample or around £70.44 per Sleepio user. Secondary analyses suggest that savings may be driven primarily by reductions in prescribing.ConclusionSleepio rollout reduced primary care costs. National adoption of Sleepio may reduce primary care costs by £20 million in the first year. The expected impact on primary care costs in any particular setting will depend on the uptake of Sleepio.

Cost-effectiveness and cost-utility evaluation of the individual vs. group transdiagnostic psychological treatment for emotional disorders in Primary Care (PsicAP-Costs) v2

2021 ◽  
Author(s):  
Angel Aguilera-Martin ◽  
Mario Gálvez-Lara ◽  
Fátima Cuadrado ◽  
Eliana Moreno ◽  
Francisco García-Torres ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Emotional Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Cognitive Behavioural ◽  
Utility Evaluation ◽  
The Individual

The aim of this study is to compare, in cost-effectiveness and cost-utility terms, a brief transdiagnostic cognitive-behavioural therapy in two different modes, individual and group, with the treatment usually administered in primary care (TAU). Participants between 18 and 65 years old and with, according to the pretreatment evaluation, mild to moderate emotional disorders will be randomly allocated to the three clusters. They will be assessed again immediately after treatment and 6 and 12 months later. ClinicalTrials.gov: NCT04847310

scholarly journals Cost-effectiveness of computerized cognitive–behavioural therapy for the treatment of depression in primary care: findings from the Randomised Evaluation of the Effectiveness and Acceptability of Computerised Therapy (REEACT) trial

2017 ◽  
Vol 47 (10) ◽  
pp. 1825-1835 ◽  
Author(s):  
A. Duarte ◽  
S. Walker ◽  
E. Littlewood ◽  
S. Brabyn ◽  
C. Hewitt ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Scenario Analyses ◽  
Cognitive Behavioural ◽  
Life Years ◽  
Gp Care ◽  
The Cost

BackgroundComputerized cognitive–behavioural therapy (cCBT) forms a core component of stepped psychological care for depression. Existing evidence for cCBT has been informed by developer-led trials. This is the first study based on a large independent pragmatic trial to assess the cost-effectiveness of cCBT as an adjunct to usual general practitioner (GP) care compared with usual GP care alone and to establish the differential cost-effectiveness of a free-to-use cCBT programme (MoodGYM) in comparison with a commercial programme (Beating the Blues) in primary care.MethodCosts were estimated from a healthcare perspective and outcomes measured using quality-adjusted life years (QALYs) over 2 years. The incremental cost-effectiveness of each cCBT programme was compared with usual GP care. Uncertainty was estimated using probabilistic sensitivity analysis and scenario analyses were performed to assess the robustness of results.ResultsNeither cCBT programme was found to be cost-effective compared with usual GP care alone. At a £20 000 per QALY threshold, usual GP care alone had the highest probability of being cost-effective (0.55) followed by MoodGYM (0.42) and Beating the Blues (0.04). Usual GP care alone was also the cost-effective intervention in the majority of scenario analyses. However, the magnitude of the differences in costs and QALYs between all groups appeared minor (and non-significant).ConclusionsTechnically supported cCBT programmes do not appear any more cost-effective than usual GP care alone. No cost-effective advantage of the commercially developed cCBT programme was evident compared with the free-to-use cCBT programme. Current UK practice recommendations for cCBT may need to be reconsidered in the light of the results.

scholarly journals Cognitive–behavioural therapy v. usual care in recurrent depression

2008 ◽  
Vol 193 (6) ◽  
pp. 505-506 ◽  
Author(s):  
Henk Jan Conradi ◽  
Peter de Jonge ◽  
Johan Ormel
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Beck Depression Inventory ◽  
Cognitive Behavioural Therapy ◽  
Acute Phase ◽  
Behavioural Therapy ◽  
Recurrent Depression ◽  
Cognitive Behavioural ◽  
Cognitive Problems

SummaryWe examined in a primary care sample whether acute-phase cognitive–behavioural therapy (CBT) would be more effective than usual care for patients with multiple prior episodes of depression. Depression outcome was based on a 3-monthly administered Beck Depression Inventory (BDI) during a 2-year follow-up. We confirmed that in patients with four or more prior episodes, CBT outperformed usual care by four points on the BDI, but not in patients with three or fewer prior episodes. Subsequent analyses suggested that CBT may be able to tackle cognitive problems related to rumination in patients with recurrent depression.

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