Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms

Chronic pain and depression are frequently comorbid conditions associated with significant health care and social costs. This study examined the cost-utility and cost-effectiveness of videoconference-based group forms of Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for D...

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Autores: Sanabria-Mazo, Juan P., D'Amico, Francesco, Cardeñosa, Eugenia, Ferrer Forés, Maria Montserrat, Edo, Sílvia, Borràs, Xavier, McCracken, Lance M., Feliu-Soler, Albert, Sanz Ruiz, Antoni, Luciano, Juan V.
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/68351
Acesso em linha:http://hdl.handle.net/10230/68351
http://dx.doi.org/10.1016/j.jpain.2024.01.337
Access Level:acceso abierto
Palavra-chave:Acceptance and commitment therapy
Behavioral activation therapy
Chronic low back pain
Cost-effectiveness
Cost-utility
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spelling Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptomsSanabria-Mazo, Juan P.D'Amico, FrancescoCardeñosa, EugeniaFerrer Forés, Maria MontserratEdo, SílviaBorràs, XavierMcCracken, Lance M.Feliu-Soler, AlbertSanz Ruiz, AntoniLuciano, Juan V.Acceptance and commitment therapyBehavioral activation therapyChronic low back painCost-effectivenessCost-utilityChronic pain and depression are frequently comorbid conditions associated with significant health care and social costs. This study examined the cost-utility and cost-effectiveness of videoconference-based group forms of Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD), as a complement to treatment-as-usual (TAU), for patients with chronic low back pain (CLBP) plus depressive symptoms, compared to TAU alone. A trial-based economic evaluation (n = 234) was conducted from a governmental and health care perspective with a time horizon of 12 months. Primary outcomes were the Brief Pain Inventory-Interference Scale (BPI-IS) and Quality Adjusted Life Year. Compared to TAU, ACT achieved a significant reduction in total costs (d = .47), and BATD achieved significant reductions in indirect (d = .61) and total costs (d = .63). Significant improvements in BPI-IS (d = .73 and d = .66, respectively) and Quality Adjusted Life Year scores (d = .46 and d = .28, respectively) were found in ACT and BATD compared to TAU. No significant differences in costs and outcomes were found between ACT and BATD. In the intention-to-treat analyses, from the governmental and health care perspective, no significant differences in cost reduction and incremental effects were identified in the comparison between ACT, BATD, and TAU. However, in the complete case analysis, significant incremental effects of ACT (∆BPI-IS = -1.57 and -1.39, respectively) and BATD (∆BPI-IS = -1.08 and -1.04, respectively) compared with TAU were observed. In the per-protocol analysis, only the significant incremental effects of ACT (∆BPI-IS = -1.68 and -1.43, respectively) compared to TAU were detected. In conclusion, ACT and BATD might be efficient options in the management of CLBP plus comorbid depression symptoms as compared to usual care. However, no clear difference was found in the comparison between the 2 active therapies regarding cost-effectiveness or cost-utility. PERSPECTIVE: The economic evaluation of psychological therapies for the management of complex conditions can be used in decision-making and resource allocation. This study provides evidence that ACT and BATD are more effective and involve a greater reduction in costs than usual care in the management of CLBP plus comorbid depressive symptoms. TRIAL NUMBER: NCT04140838.Elsevier202420242024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/68351http://dx.doi.org/10.1016/j.jpain.2024.01.337reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésJ Pain. 2024 Jul;25(7):104472© 2024 The Author(s). Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/683512026-06-12T07:21:37Z
dc.title.none.fl_str_mv Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
title Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
spellingShingle Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
Sanabria-Mazo, Juan P.
Acceptance and commitment therapy
Behavioral activation therapy
Chronic low back pain
Cost-effectiveness
Cost-utility
title_short Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
title_full Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
title_fullStr Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
title_full_unstemmed Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
title_sort Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms
dc.creator.none.fl_str_mv Sanabria-Mazo, Juan P.
D'Amico, Francesco
Cardeñosa, Eugenia
Ferrer Forés, Maria Montserrat
Edo, Sílvia
Borràs, Xavier
McCracken, Lance M.
Feliu-Soler, Albert
Sanz Ruiz, Antoni
Luciano, Juan V.
author Sanabria-Mazo, Juan P.
author_facet Sanabria-Mazo, Juan P.
D'Amico, Francesco
Cardeñosa, Eugenia
Ferrer Forés, Maria Montserrat
Edo, Sílvia
Borràs, Xavier
McCracken, Lance M.
Feliu-Soler, Albert
Sanz Ruiz, Antoni
Luciano, Juan V.
author_role author
author2 D'Amico, Francesco
Cardeñosa, Eugenia
Ferrer Forés, Maria Montserrat
Edo, Sílvia
Borràs, Xavier
McCracken, Lance M.
Feliu-Soler, Albert
Sanz Ruiz, Antoni
Luciano, Juan V.
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Acceptance and commitment therapy
Behavioral activation therapy
Chronic low back pain
Cost-effectiveness
Cost-utility
topic Acceptance and commitment therapy
Behavioral activation therapy
Chronic low back pain
Cost-effectiveness
Cost-utility
description Chronic pain and depression are frequently comorbid conditions associated with significant health care and social costs. This study examined the cost-utility and cost-effectiveness of videoconference-based group forms of Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD), as a complement to treatment-as-usual (TAU), for patients with chronic low back pain (CLBP) plus depressive symptoms, compared to TAU alone. A trial-based economic evaluation (n = 234) was conducted from a governmental and health care perspective with a time horizon of 12 months. Primary outcomes were the Brief Pain Inventory-Interference Scale (BPI-IS) and Quality Adjusted Life Year. Compared to TAU, ACT achieved a significant reduction in total costs (d = .47), and BATD achieved significant reductions in indirect (d = .61) and total costs (d = .63). Significant improvements in BPI-IS (d = .73 and d = .66, respectively) and Quality Adjusted Life Year scores (d = .46 and d = .28, respectively) were found in ACT and BATD compared to TAU. No significant differences in costs and outcomes were found between ACT and BATD. In the intention-to-treat analyses, from the governmental and health care perspective, no significant differences in cost reduction and incremental effects were identified in the comparison between ACT, BATD, and TAU. However, in the complete case analysis, significant incremental effects of ACT (∆BPI-IS = -1.57 and -1.39, respectively) and BATD (∆BPI-IS = -1.08 and -1.04, respectively) compared with TAU were observed. In the per-protocol analysis, only the significant incremental effects of ACT (∆BPI-IS = -1.68 and -1.43, respectively) compared to TAU were detected. In conclusion, ACT and BATD might be efficient options in the management of CLBP plus comorbid depression symptoms as compared to usual care. However, no clear difference was found in the comparison between the 2 active therapies regarding cost-effectiveness or cost-utility. PERSPECTIVE: The economic evaluation of psychological therapies for the management of complex conditions can be used in decision-making and resource allocation. This study provides evidence that ACT and BATD are more effective and involve a greater reduction in costs than usual care in the management of CLBP plus comorbid depressive symptoms. TRIAL NUMBER: NCT04140838.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/68351
http://dx.doi.org/10.1016/j.jpain.2024.01.337
url http://hdl.handle.net/10230/68351
http://dx.doi.org/10.1016/j.jpain.2024.01.337
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv J Pain. 2024 Jul;25(7):104472
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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