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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Economic evaluation of an experience sampling method intervention in depression compared with treatment as usual using data from a randomized controlled trial

Authors: Claudia J. P. Simons, Marjan Drukker, Silvia Evers, Ghislaine A. P. G. van Mastrigt, Petra Höhn, Ingrid Kramer, Frenk Peeters, Philippe Delespaul, Claudia Menne-Lothmann, Jessica A. Hartmann, Jim van Os, Marieke Wichers

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

Experience sampling, a method for real-time self-monitoring of affective experiences, holds opportunities for person-tailored treatment. By focussing on dynamic patterns of positive affect, experience sampling method interventions (ESM-I) accommodate strategies to enhance personalized treatment of depression―at potentially low-costs. This study aimed to investigate the cost-effectiveness of an experience sampling method intervention in patients with depression, from a societal perspective.

Methods

Participants were recruited between January 2010 and February 2012 from out-patient mental health care facilities in or near the Dutch cities of Eindhoven and Maastricht, and through local advertisements. Out-patients diagnosed with major depression (n = 101) receiving pharmacotherapy were randomized into: (i) ESM-I consisting of six weeks of ESM combined with weekly feedback regarding the individual’s positive affective experiences, (ii) six weeks of ESM without feedback, or (iii) treatment as usual only. Alongside this randomised controlled trial, an economic evaluation was conducted consisting of a cost-effectiveness and a cost-utility analysis, using Hamilton Depression Rating Scale (HDRS) and quality adjusted life years (QALYs) as outcome, with willingness-to-pay threshold for a QALY set at €50,000 (based on Dutch guidelines for moderate severe to severe illnesses).

Results

The economic evaluation showed that ESM-I is an optimal strategy only when willingness to pay is around €3000 per unit HDRS and around €40,500 per QALY. ESM-I was the least favourable treatment when willingness to pay was lower than €30,000 per QALY. However, at the €50,000 willingness-to-pay threshold, ESM-I was, with a 46% probability, the most favourable treatment (base-case analysis). Sensitivity analyses confirmed the robustness of these results.

Conclusions

We may tentatively conclude that ESM-I is a cost-effective add-on intervention to pharmacotherapy in outpatients with major depression.

Trial registration

Netherlands Trial register, NTR1974.
Appendix
Available only for authorised users
Literature
1.
Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2197–223.CrossRefPubMed
2.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2163–96.CrossRefPubMed
3.
4.
Donohue JM, Pincus HA. Reducing the societal burden of depression: a review of economic costs, quality of care and effects of treatment. PharmacoEconomics. 2007;25:7–24.CrossRefPubMed
5.
Graaf R, Have M, Gool C, Dorsselaer S. Prevalence of mental disorders and trends from 1996 to 2009. Results from the Netherlands mental health survey and incidence study-2. Soc Psychiatry Psychiatr Epidemiol. 2012;47:203–13.CrossRefPubMed
6.
7.
Bijl RV, Ravelli A. Psychiatric morbidity, service use, and need for care in the general population: results of The Netherlands mental health survey and incidence study. Am J Public Health. 2000;90:602–7.CrossRefPubMedPubMedCentral
8.
Cuijpers P, Dekker J, Hollon SD, Andersson G. Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: a meta-analysis. J Clin Psychiatry. 2009;70:1219–29.CrossRefPubMed
9.
Andrews G, Issakidis C, Sanderson K, Corry J, Lapsley H. Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders. Br J Psychiatry. 2004;184:526–33.CrossRefPubMed
10.
aan het Rot M, Hogenelst K, Schoevers RA. Mood disorders in everyday life: a systematic review of experience sampling and ecological momentary assessment studies. Clin Psychol Rev. 2012;32:510–23.CrossRefPubMed
11.
Delespaul P. Assessing schizophrenia in daily life: the experience sampling method. Maastricht: University of Limburg; 1995.
12.
Myin-Germeys I, Oorschot M, Collip D, Lataster J, Delespaul P, van Os J. Experience sampling research in psychopathology: opening the black box of daily life. Psychol Med. 2009;39:1533–47.CrossRefPubMed
13.
Wichers M, Simons CJP, Kramer IMA, Hartmann JA, Lothmann C, Myin-Germeys I, et al. Momentary assessment technology as a tool to help patients with depression help themselves. Acta Psychiatr Scand. 2011;124:262–72.CrossRefPubMed
14.
Garland EL, Fredrickson B, Kring AM, Johnson DP, Meyer PS, Penn DL. Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clin Psychol Rev. 2010;30:849–64.CrossRefPubMedPubMedCentral
15.
Geschwind N, Nicolson NA, Peeters F, van Os J, Barge-Schaapveld D, Wichers M. Early improvement in positive rather than negative emotion predicts remission from depression after pharmacotherapy. Eur Neuropsychopharmacol. 2011;21:241–7.CrossRefPubMed
16.
Wichers MC, Barge-Schaapveld DQ, Nicolson NA, Peeters F, de Vries M, Mengelers R, et al. Reduced stress-sensitivity or increased reward experience: the psychological mechanism of response to antidepressant medication. Neuropsychopharmacology. 2009;34:923–31.CrossRefPubMed
17.
Kramer I, Simons CJP, Hartmann JA, Menne-Lothmann C, Viechtbauer W, Peeters F, et al. A therapeutic application of the experience sampling method in the treatment of depression: a randomized controlled trial. World Psychiatry. 2014;13:68–77.CrossRefPubMedPubMedCentral
18.
Agras WS, Taylor CB, Feldman DE, Losch M, Burnett KF. Developing computer-assisted therapy for the treatment of obesity. Behav Ther. 1990;21:99–109.CrossRef
19.
Kenardy JA, Dow MG, Johnston DW, Newman MG, Thomson A, Taylor CB. A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multicenter trial. J Consult Clin Psychol. 2003;71:1068–75.CrossRefPubMed
20.
First M, Spitzer R, Gibbon M, Williams J. Structured clinical interview for DSM-IV-TR Axis I disorders, research version, patient edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute; 2002.
21.
22.
Hartmann JA, Wichers M, Menne-Lothmann C, Kramer I, Viechtbauer W, Peeters F, et al. Experience sampling-based personalized feedback and positive affect: a randomized controlled trial in depressed patients. PLoS One. 2015;10:e0128095.CrossRefPubMedPubMedCentral
23.
Csikszentmihalyi M, Larson R. Validity and reliability of the experience-sampling method. J Nerv Ment Dis. 1987;175:526–36.CrossRefPubMed
24.
Myin-Germeys I, van Os J, Schwartz JE, Stone AA, Delespaul PA. Emotional reactivity to daily life stress in psychosis. Arch Gen Psychiatry. 2001;58:1137–44.CrossRefPubMed
25.
Wichers M, Myin-Germeys I, Jacobs N, Peeters F, Kenis G, Derom C, et al. Genetic risk of depression and stress-induced negative affect in daily life. Br J Psychiatry. 2007;191:218–23.CrossRefPubMed
26.
Myin-Germeys I, Birchwood M, Kwapil T. From environment to therapy in psychosis: a real-world momentary assessment approach. Schizophr Bull. 2011;37:244–7.CrossRefPubMedPubMedCentral
27.
Andreasen NC, Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005;162:441–9.CrossRefPubMed
28.
The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. The EuroQol group. Health Policy. 1990;16:199–208.CrossRef
29.
30.
Dolan P, Gudex C, Kind P, Williams A. The time trade-off method: results from a general population study. Health Econ. 1996;5:141–54.CrossRefPubMed
31.
Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University press; 2005.
32.
Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al. Consolidated health economic evaluation reporting standards (CHEERS)—explanation and elaboration: a report of the ISPOR health economic evaluation publication guidelines good reporting practices task force. Value Health. 2013;16:231–50.CrossRefPubMed
33.
34.
Hakkaart-van RL. Handleiding TiC-P, vragenlijst voor zorggebruik en productieverliezen bij psychiatrische aandoeningen [manual TiC-P, questionnaire for costs associated with psychiatric illness]. Rotterdam: Institute for Medical Technology Assessment, Erasmus University; 2010.
35.
Koopmanschap M, Burdorf A, Jacob K, Meerding WJ, Brouwer W, Severens H. Measuring productivity changes in economic evaluation. PharmacoEconomics. 2005;23:47–54.CrossRefPubMed
36.
Koopmanschap M, Meerding WJ, Evers S, Severens J, Burdorf A, Brouwer W. Handleiding voor het gebruik van PRODISQ versie 2.1 [Manual for the use of PRODISQ version 2.1]. 2004.
37.
Hakkaart-van Roijen L, Tan S, Bouwmans C. Handleiding voor kostenonderzoek; methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg. Geactualiseerde versie 2010 [Manual for costs research]. In. Edited by Instituut voor Medical Technology Assessment EUR. Diemen; 2011.
38.
39.
Brouwer WB, van Exel NJ, Koopmanschap MA, Rutten FF. Productivity costs before and after absence from work: as important as common? Health Policy. 2002;61:173–87.CrossRefPubMed
40.
Meerding WJ, IJzelenberg W, Koopmanschap MA, Severens JL, Burdorf A. Health problems lead to considerable productivity loss at work among workers with high physical load jobs. J Clin Epidemiol. 2005;58:517–23.CrossRefPubMed
41.
Van Saase L, Zwaap J, Knies S, Van der Meijden C, Staal P, Van der Heiden L. Kosteneffectiviteit in de praktijk. Diemen: Zorginstituut Nederland; 2015.
42.
Green C, Richards DA, Hill JJ, Gask L, Lovell K, Chew-Graham C, et al. Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET). PLoS One. 2014;9:e104225.CrossRefPubMedPubMedCentral
43.
Jacob V, Chattopadhyay SK, Sipe TA, Thota AB, Byard GJ, Chapman DP. Economics of collaborative care for management of depressive disorders: a community guide systematic review. Am J Prev Med. 2012;42:539–49.CrossRefPubMed
44.
Vallejo-Torres L, Castilla I, Gonzalez N, Hunter R, Serrano-Perez P, Perestelo-Perez L. Cost-effectiveness of electroconvulsive therapy compared to repetitive transcranial magnetic stimulation for treatment-resistant severe depression: a decision model. Psychol Med. 2015;45:1459–70.CrossRefPubMed
45.
Barge-Schaapveld DQ, Nicolson NA. Effects of antidepressant treatment on the quality of daily life: an experience sampling study. J Clin Psychiatry. 2002;63:477–85.CrossRefPubMed
46.
Hegerl U, Mergl R. The clinical significance of antidepressant treatment effects cannot be derived from placebo-verum response differences. J Psychopharmacol. 2010;24:445–8.CrossRefPubMed
47.
NICE. Depression: management of depression in primary and secondary care. Clinical practice guideline no. 23. London: National Institute for Clinical Excellence; 2004.
48.
StataCorp. Stata statistical software: release 13. College Station: Statacorp LP; 2013.
49.
Van Asselt AD, Van Mastrigt GA, Dirksen CD, Arntz A, Severens JL, Kessels AG. How to deal with cost differences at baseline. PharmacoEconomics. 2009;27:519–28.CrossRefPubMed
50.
Fenwick E, Claxton K, Sculpher M. Representing uncertainty: the role of cost-effectiveness acceptability curves. Health Econ. 2001;10:779–87.CrossRefPubMed
51.
Lamers LM, McDonnell J, Stalmeier PF, Krabbe PF, Busschbach JJ. The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies. Health Econ. 2006;15:1121–32.CrossRefPubMed
52.
Kelly J, Gooding P, Pratt D, Ainsworth J, Welford M, Tarrier N. Intelligent real-time therapy: harnessing the power of machine learning to optimise the delivery of momentary cognitive-behavioural interventions. J Ment Health. 2012;21:404–14.CrossRefPubMed
53.
54.
van der Feltz-Cornelis CM, van Os J, Knappe S, Schumann G, Vieta E, Wittchen HU, et al. Towards horizon 2020: challenges and advances for clinical mental health research - outcome of an expert survey. Neuropsychiatr Dis Treat. 2014;10:1057–68.CrossRefPubMedPubMedCentral
55.
Driessen E, Cuijpers P, Hollon SD, Dekker JJ. Does pretreatment severity moderate the efficacy of psychological treatment of adult outpatient depression? A meta-analysis. J Consult Clin Psychol. 2010;78:668–80.CrossRefPubMed
56.
van der Lem R, van der Wee NJ, van Veen T, Zitman FG. The generalizability of antidepressant efficacy trials to routine psychiatric out-patient practice. Psychol Med. 2011;41:1353–63.CrossRefPubMed
57.
Zimmerman M, Mattia JI, Posternak MA. Are subjects in pharmacological treatment trials of depression representative of patients in routine clinical practice? Am J Psychiatry. 2002;159:469–73.CrossRefPubMed
58.
Khan A, Redding N, Brown WA. The persistence of the placebo response in antidepressant clinical trials. J Psychiatr Res. 2008;42:791–6.CrossRefPubMed
59.
Hendriks MR, Al MJ, Bleijlevens MH, van Haastregt JC, Crebolder HF, van Eijk JT, et al. Continuous versus intermittent data collection of health care utilization. Med Decis Mak. 2013;33:998–1008.CrossRef
60.
Rothman KJ, Greenland S. Modern Epidemiology. 2nd ed. Philadelphia: Lippincott-Raven; 1998.
Metadata
Title
Economic evaluation of an experience sampling method intervention in depression compared with treatment as usual using data from a randomized controlled trial
Authors
Claudia J. P. Simons
Marjan Drukker
Silvia Evers
Ghislaine A. P. G. van Mastrigt
Petra Höhn
Ingrid Kramer
Frenk Peeters
Philippe Delespaul
Claudia Menne-Lothmann
Jessica A. Hartmann
Jim van Os
Marieke Wichers
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1577-7

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