Cost-Effectiveness of Guided Self-Help Treatment for Recurrent Binge Eating
Cost-Effectiveness of Guided Self-Help Treatment for Recurrent Binge Eating
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DOI：
10.1037/a0018982
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发表时间：
2010-06-01
影响因子：
5.9
通讯作者：
Kraemer, Helena C.
中科院分区：
文献类型：
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作者：
Lynch, Frances L.;Striegel-Moore, Ruth H.;Kraemer, Helena C.
目的：对复发性暴食症采取有效的治疗方法取决于成本和收益的平衡。利用最近一项随机对照试验的数据，我们对认知行为疗法引导的自助干预 (CBT-GSH) 与常规治疗 (TAU) 进行比较，对治疗反复暴食症进行了增量成本效益分析 (CEA)。方法：参与者是 HMO 的 123 名成年成员（平均年龄 = 37.2 岁，91.9% 为女性，96.7% 非西班牙裔白人），他们符合饮食失调标准，包括通过饮食失调检查测量的暴饮暴食（C. G. Fairborn & Z. Cooper, 1993）。参与者被随机分配接受常规治疗 (TAU) 或 TAU 加 CBT-GSH。临床结果是无暴饮暴食天数和质量调整生命年（QALY）；社会总成本是根据患者成本、健康计划和相关成本来估算的。结果：与仅接受 TAU 的患者相比，接受 TAU 加 CBT-GSH 的患者在干预后的 12 个月内无暴饮暴食天数增加了 25.2 天，社会总成本降低了 427 美元（CEA 增量比率为每个无暴食日 - 20.23 美元或每个 QALY - 26,847 美元）。 TAU 加 CBT-GSH 组的成本较低是由于该组中 TAU 服务的使用减少，从而导致 TAU 加 CBT 组的净成本较低，尽管 CBT-GSH 产生额外成本。结论：研究结果支持 CBT-GSH 传播用于治疗复发性暴食症。
Objective: Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits. Using data from a recent randomized controlled trial, we conducted an incremental cost-effectiveness analysis (CEA) of a cognitive behavioral therapy guided self-help intervention (CBT-GSH) to treat recurrent binge eating compared to treatment as usual (TAU). Method: Participants were 123 adult members of an HMO (mean age = 37.2 years, 91.9% female, 96.7% non-Hispanic White) who met criteria for eating disorders involving binge eating as measured by the Eating Disorder Examination (C. G. Fairborn & Z. Cooper, 1993). Participants were randomized either to treatment as usual (TAU) or to TAU plus CBT-GSH. The clinical outcomes were binge-free days and qualityadjusted life years (QALYs); total societal cost was estimated using costs to patients and the health plan and related costs. Results: Compared to those receiving TAU only, those who received TAU plus CBT-GSH experienced 25.2 more binge-free days and had lower total societal costs of $427 over 12 months following the intervention (incremental CEA ratio of -$20.23 per binge-free day or -$26,847 per QALY). Lower costs in the TAU plus CBT-GSH group were due to reduced use of TAU services in that group, resulting in lower net costs for the TAU plus CBT group despite the additional cost of CBT-GSH. Conclusions: Findings support CBT-GSH dissemination for recurrent binge-eating treatment.