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Moreno-Peral P, Conejo-Cerón S, Wijnen B, Lokkerbol J, Fernández A, Smit F, Bellón JÁ. Health-Economic Evaluation of Psychological Interventions for Anxiety Prevention: A Systematic Review. Psychiatr Serv 2024; 75:667-677. [PMID: 38410039 DOI: 10.1176/appi.ps.20230101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
OBJECTIVE Although evidence supports the effectiveness of psychological interventions for prevention of anxiety, little is known about their cost-effectiveness. The aim of this study was to conduct a systematic review of health-economic evaluations of psychological interventions for anxiety prevention. METHODS PubMed, PsycInfo, Web of Science, Embase, Cochrane Central Register of Controlled Trials, EconLit, National Health Service (NHS) Economic Evaluations Database, NHS Health Technology Assessment, and OpenGrey databases were searched electronically on December 23, 2022. Included studies focused on economic evaluations based on randomized controlled trials of psychological interventions to prevent anxiety. Study data were extracted, and the quality of the selected studies was assessed by using the Consensus on Health Economic Criteria and the Cochrane risk-of-bias tool. RESULTS All included studies (N=5) had economic evaluations that were considered to be of good quality. In two studies, the interventions showed favorable cost-effectiveness compared with usual care groups. In one study, the intervention was not cost-effective. Findings from another study cast doubt on the cost-effectiveness of the intervention, and the cost-effectiveness of the intervention in the remaining study could not be established. CONCLUSIONS Although the findings suggest some preliminary evidence of cost-effectiveness of psychological interventions for preventing anxiety, they were limited by the small number of included studies. Additional research on the cost-effectiveness of psychological interventions for anxiety in different countries and populations is required.
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Affiliation(s)
- Patricia Moreno-Peral
- IBIMA Plataforma BIONAND, Málaga, Spain (Moreno-Peral, Conejo-Cerón); Institute of Health Carlos III (ISCIII), Madrid (Moreno-Peral, Conejo-Cerón); Department of Personality, Evaluation and Psychological Treatment (Moreno-Peral) and Department of Public Health and Psychiatry (Bellón), University of Málaga, Málaga, Spain; Centre of Economic Evaluation and Machine Learning, Trimbos Institute, Utrecht, the Netherlands (Wijnen, Lokkerbol, Smit); Barcelona Agency of Public Health, Community Health Service, and Center for Biomedical Research in Epidemiology and Public Health, Barcelona, Spain (Fernández); Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Smit); El Palo Health Centre, Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain (Bellón)
| | - Sonia Conejo-Cerón
- IBIMA Plataforma BIONAND, Málaga, Spain (Moreno-Peral, Conejo-Cerón); Institute of Health Carlos III (ISCIII), Madrid (Moreno-Peral, Conejo-Cerón); Department of Personality, Evaluation and Psychological Treatment (Moreno-Peral) and Department of Public Health and Psychiatry (Bellón), University of Málaga, Málaga, Spain; Centre of Economic Evaluation and Machine Learning, Trimbos Institute, Utrecht, the Netherlands (Wijnen, Lokkerbol, Smit); Barcelona Agency of Public Health, Community Health Service, and Center for Biomedical Research in Epidemiology and Public Health, Barcelona, Spain (Fernández); Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Smit); El Palo Health Centre, Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain (Bellón)
| | - Ben Wijnen
- IBIMA Plataforma BIONAND, Málaga, Spain (Moreno-Peral, Conejo-Cerón); Institute of Health Carlos III (ISCIII), Madrid (Moreno-Peral, Conejo-Cerón); Department of Personality, Evaluation and Psychological Treatment (Moreno-Peral) and Department of Public Health and Psychiatry (Bellón), University of Málaga, Málaga, Spain; Centre of Economic Evaluation and Machine Learning, Trimbos Institute, Utrecht, the Netherlands (Wijnen, Lokkerbol, Smit); Barcelona Agency of Public Health, Community Health Service, and Center for Biomedical Research in Epidemiology and Public Health, Barcelona, Spain (Fernández); Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Smit); El Palo Health Centre, Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain (Bellón)
| | - Joran Lokkerbol
- IBIMA Plataforma BIONAND, Málaga, Spain (Moreno-Peral, Conejo-Cerón); Institute of Health Carlos III (ISCIII), Madrid (Moreno-Peral, Conejo-Cerón); Department of Personality, Evaluation and Psychological Treatment (Moreno-Peral) and Department of Public Health and Psychiatry (Bellón), University of Málaga, Málaga, Spain; Centre of Economic Evaluation and Machine Learning, Trimbos Institute, Utrecht, the Netherlands (Wijnen, Lokkerbol, Smit); Barcelona Agency of Public Health, Community Health Service, and Center for Biomedical Research in Epidemiology and Public Health, Barcelona, Spain (Fernández); Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Smit); El Palo Health Centre, Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain (Bellón)
| | - Anna Fernández
- IBIMA Plataforma BIONAND, Málaga, Spain (Moreno-Peral, Conejo-Cerón); Institute of Health Carlos III (ISCIII), Madrid (Moreno-Peral, Conejo-Cerón); Department of Personality, Evaluation and Psychological Treatment (Moreno-Peral) and Department of Public Health and Psychiatry (Bellón), University of Málaga, Málaga, Spain; Centre of Economic Evaluation and Machine Learning, Trimbos Institute, Utrecht, the Netherlands (Wijnen, Lokkerbol, Smit); Barcelona Agency of Public Health, Community Health Service, and Center for Biomedical Research in Epidemiology and Public Health, Barcelona, Spain (Fernández); Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Smit); El Palo Health Centre, Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain (Bellón)
| | - Filip Smit
- IBIMA Plataforma BIONAND, Málaga, Spain (Moreno-Peral, Conejo-Cerón); Institute of Health Carlos III (ISCIII), Madrid (Moreno-Peral, Conejo-Cerón); Department of Personality, Evaluation and Psychological Treatment (Moreno-Peral) and Department of Public Health and Psychiatry (Bellón), University of Málaga, Málaga, Spain; Centre of Economic Evaluation and Machine Learning, Trimbos Institute, Utrecht, the Netherlands (Wijnen, Lokkerbol, Smit); Barcelona Agency of Public Health, Community Health Service, and Center for Biomedical Research in Epidemiology and Public Health, Barcelona, Spain (Fernández); Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Smit); El Palo Health Centre, Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain (Bellón)
| | - Juan Ángel Bellón
- IBIMA Plataforma BIONAND, Málaga, Spain (Moreno-Peral, Conejo-Cerón); Institute of Health Carlos III (ISCIII), Madrid (Moreno-Peral, Conejo-Cerón); Department of Personality, Evaluation and Psychological Treatment (Moreno-Peral) and Department of Public Health and Psychiatry (Bellón), University of Málaga, Málaga, Spain; Centre of Economic Evaluation and Machine Learning, Trimbos Institute, Utrecht, the Netherlands (Wijnen, Lokkerbol, Smit); Barcelona Agency of Public Health, Community Health Service, and Center for Biomedical Research in Epidemiology and Public Health, Barcelona, Spain (Fernández); Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Smit); El Palo Health Centre, Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain (Bellón)
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Caldwell DM, Thorn JC. Commentary/Response: Economic evidence should be routinely collected and reported for studies of intervention effectiveness in mental health. A commentary on Vartiainen et al. (2022). Child Adolesc Ment Health 2023; 28:327-329. [PMID: 36596719 DOI: 10.1111/camh.12635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 01/05/2023]
Abstract
Anxiety and related disorders are increasingly widespread amongst children and adolescents. Preventing mental health disorders from developing has the potential to realise long-term benefits for children and adolescents. In their paper, 'Economic evidence of preventive interventions for anxiety disorders in children and adolescents-a systematic review', Vartiainen et al. conducted a systematic review to examine economic evidence of interventions for the primary prevention of anxiety disorders in children and adolescents, under 18 years of age. Five articles were eligible for inclusion in the review, of which two were model-based economic evaluations and three conducted alongside randomised controlled trials (RCTs). All five papers used either a cost-effectiveness analysis (CEA) or cost-utility analysis (CUA) as their main analysis. Vartiainen et al. concluded that, due to the small number of studies and relatively small sample sizes, the evidence for the cost-effectiveness of anxiety prevention interventions is weak. In this commentary, the challenges of conducting economic evaluations for prevention interventions are briefly outlined and Vartiainen et al.'s findings are discussed in the context of two further reviews of economic studies, published in 2021. The first focuses on the prevention of anxiety and depression in children and young people and the second takes a broader perspective and also includes interventions for mental health promotion. Both additional reviews note the small number of published economic evaluations, and all three reviews are united in their call for economic evaluations to be conducted alongside all future mental health prevention intervention trials.
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Affiliation(s)
- Deborah M Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanna C Thorn
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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