The cost effectiveness of cognitive behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face
The cost effectiveness of cognitive behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face
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DOI：
10.1016/j.brat.2009.02.006
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发表时间：
2009-06-01
影响因子：
4.1
通讯作者：
Lancanster, Kathy
中科院分区：
文献类型：
--
作者：
Crow, Scott J.;Mitchell, James E.;Lancanster, Kathy
目的：已经开发出许多治疗神经性贪食症的有效疗法，但它们很少被使用，部分原因是传播问题。本研究的目的是检查远程医疗提供神经性贪食症认知行为疗法的成本效益。方法：一项针对神经性贪食症的面对面认知行为疗法与远程医疗认知行为疗法的随机对照试验。 128 名患有 DSM-IV 神经性贪食症或饮食失调（非其他特定的神经性贪食症亚综合征变异）的女性被随机接受 16 周内的 20 次治疗。从社会角度进行了成本效益分析。结果：每个康复（戒断）受试者的面对面 CBT 总成本为 9324.68 美元，远程医疗 CBT 为 7300.40 美元。成本差异主要是由治疗师的旅行费用造成的。检查治疗费用、汽油费用和远程医疗连接费用的敏感性分析得出了基本相似的结果。讨论：在这项研究中，面对面提供的 CBT 和通过远程医疗提供的 CBT 效果相似，并且远程医疗提供的成本要低得多。这些发现强调了远程医疗方法对饮食失调治疗和一般精神病治疗的潜在适用性。 (c) 2009 Elsevier Ltd. 保留所有权利。
Objective: A number of effective treatments for bulimia nervosa have been developed, but they are infrequently used, in part due to problems with dissemination. The goal of this study was to examine the cost effectiveness of telemedicine delivery of cognitive behavioral therapy for bulimia nervosa.Method: A randomized controlled trial of face-to-face versus telemedicine cognitive behavioral therapy for bulimia nervosa. One hundred twenty eight women with DSM-IV bulimia nervosa or eating disorder, not otherwise specified subsyndromal variants of bulimia nervosa were randomized to 20 sessions of treatment over 16 weeks. A cost effectiveness analysis from a societal perspective was conducted.Results: The total cost per recovered (abstinent) subject was $9324.68 for face-to-face CBT, and $7300.40 for telemedicine CBT. The cost differential was accounted for largely by therapist travel costs. Sensitivity analyses examining therapy session costs, gasoline costs and telemedicine connection costs yielded fundamentally similar results.Discussion: In this study, CBT delivered face-to-face and via telemedicine were similarly effective, and telemedicine delivery Cost Substantially less. These findings underscore the potential applicability of telemedicine approaches to eating disorder treatment and psychiatric treatment in general. (c) 2009 Elsevier Ltd. All rights reserved.