A pilot economic evaluation of computerized cognitive behavioral therapy for alcohol use disorder as an addition and alternative to traditional therapy.
A pilot economic evaluation of computerized cognitive behavioral therapy for alcohol use disorder as an addition and alternative to traditional therapy.
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DOI：
10.1111/acer.14601
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Kiluk BD
中科院分区：
文献类型：
--
作者：
Kacmarek CN;Yates BT;Nich C;Kiluk BD
基于计算机的认知行为疗法（CBT）可能是一种成本较低的方法，可以增加酒精使用障碍（AUD）循证治疗的传播和实施。然而，计算机提供的干预措施的成本，成本效益和成本效益的全面评价是罕见的。本研究使用来自一项已完成的随机临床试验的数据来评估基于计算机的CBT版本（CBT 4CBT）用于AUD的成本效益和成本效益。63名受试者在门诊治疗机构随机接受以下治疗之一，并参加至少一次治疗：（1）常规治疗（TAU），（2）CBT 4CBT+常规治疗（CBT 4CBT +TAU），或（3）CBT 4CBT+简短监测。每名参与者的中位方案治疗成本在不同条件下存在显著差异，H（2）= 8.40，p = 0.02，因此CBT 4CBT +TAU和CBT 4CBT+监测每名参与者的成本均显著高于TAU。然而，当包括非协议治疗费用时，每位参与者的总治疗费用在不同条件下没有显着差异。中位增量成本效益比（ICER）显示，在TAU基础上添加CBT 4CBT的成本为35.08美元，以在基线和8周治疗方案结束之间每月减少一个额外的饮酒日：CBT 4CBT +TAU比TAU更昂贵，更有效。CBT 4CBT+监测成本为33.70美元，每月减少一个额外的饮酒日，因为CBT 4CBT+监测比TAU成本更低，在治疗终止时更有效，但并不显著。净效益分析表明，无论病情如何，治疗费用都不能抵消基线和6个月随访之间与医疗保健使用、刑事司法参与和就业中断相关的每月费用。每种情况的效益-成本比相似。这项试点经济评估的结果表明，为期8周的CBT 4CBT疗程可能是一种具有成本效益的补充，也是AUD标准门诊治疗的潜在替代方案。需要进行更多的研究，以得出有关向参加标准门诊治疗的寻求治疗的个人提供CBT 4CBT的成本效益的结论。
Computer-based delivery of cognitive behavioral therapy (CBT) may be a less costly approach to increase dissemination and implementation of evidence-based treatments for alcohol use disorder (AUD). However, comprehensive evaluations of costs, cost-effectiveness, and cost-benefit of computer-delivered interventions are rare. This study used data from a completed randomized clinical trial to evaluate the cost-effectiveness and cost-benefit of a computer-based version of CBT (CBT4CBT) for AUD. Sixty-three participants were randomized to one of the following treatments at an outpatient treatment facility and attended at least one session: (1) treatment as usual (TAU), (2) CBT4CBT plus treatment as usual (CBT4CBT+TAU), or (3) CBT4CBT plus brief monitoring. Median protocol treatment costs per participant significantly differed between conditions, H(2) = 8.40, p = .02, such that CBT4CBT+TAU and CBT4CBT+monitoring each cost significantly more per participant than TAU. However, when non-protocol treatment costs were included, total treatment costs per participant did not significantly differ between conditions. Median incremental cost-effective ratios (ICERs) revealed that it cost $35.08 to add CBT4CBT to TAU to produce a reduction of one additional drinking day per month between baseline and the end of the 8-week treatment protocol: CBT4CBT+TAU was more costly and more effective than TAU. CBT4CBT+monitoring cost −$33.70 to produce a reduction of one additional drinking day per month because CBT4CBT+monitoring was less costly than TAU and more effective at treatment termination, yet not significantly so. Net benefit analyses suggested that costs of treatment, regardless of condition, did not offset monthly costs related to healthcare use, criminal justice involvement, and employment disruption between baseline and 6-month follow-up. Benefit-cost ratios were similar for each condition. Results of this pilot economic evaluation suggest an 8-week course of CBT4CBT may be a cost-effective addition and potential alternative to standard outpatient treatment for AUD. Additional research is needed to generate conclusions about the cost-benefit of providing CBT4CBT to treatment-seeking individuals participating in standard outpatient treatment.
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影响因子：
5.4
作者：
French, MT;Salomé, HJ;Carney, M
通讯作者：
Carney, M
影响因子：
25.8
作者：
Grant BF;Goldstein RB;Saha TD;Chou SP;Jung J;Zhang H;Pickering RP;Ruan WJ;Smith SM;Huang B;Hasin DS
通讯作者：
Hasin DS
影响因子：
3.4
作者：
Ettner, SL;Huang, D;Hser, YI
通讯作者：
Hser, YI
DOI：
10.1111/add.13715
发表时间：
2017-05
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Dallery J;Raiff BR;Kim SJ;Marsch LA;Stitzer M;Grabinski MJ
通讯作者：
Grabinski MJ
影响因子：
6.7
作者：
Carroll, Kathleen M.;Rounsaville, Bruce J.
通讯作者：
Rounsaville, Bruce J.