Are day-long psycho-educational workshops cost-effective? Eva-Maria - - PowerPoint PPT Presentation

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Are day-long psycho-educational workshops cost-effective? Eva-Maria - - PowerPoint PPT Presentation

Oct 15, 2022 439 likes •673 views

Are day-long psycho-educational workshops cost-effective? Eva-Maria Bonin, Jennifer Beecham The intervention(s) One-day CBT workshops to improve self- confidence in a community setting Participants included in economic evaluation:

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Are day-long psycho-educational workshops cost-effective?

Eva-Maria Bonin, Jennifer Beecham

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The intervention(s)

One-day CBT workshops to improve self- confidence in a community setting Participants included in economic evaluation:

179 intervention (79%) 202 control (87%)

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Economic evaluation – methods

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Cost- effectiveness

Outcomes Costs Service use

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Supports received by people with low self-confidence

 CSRI (Beecham & Knapp, 2001)

3 months retrospective, self-reported measure

 Comprehensive picture of service use

Hospital services Primary care Specialist mental health services Social work Counselling Alternative therapy Self-help Third sector

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A look at selected services (bsln.)

Service Number % Inpatient 28 7% Outpatient 103 27% A & E 34 9% GP 188 49% Psychologist 84 22% Psychiatrist 25 7% Psychotherapist 33 9% Counselling 80 21% Alternative therapy 60 16% Self-help 51 13% Charities and advice centres 30 8% Helplines 48 13%

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Support cost before the intervention - average £1,046

50% 5% 19% 1% 17% 2% 4% 2%

Hospital Primary care Mental health Social work Counselling Self help Other services Medications

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Support costs at follow-up

No difference between intervention and control group

Intervention: £834 (incl. £161 intervention) Control: £841

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Outcomes

Significant improvement in BDI Significant improvement in RSES

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Economic evaluation - methods

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Cost- effectiveness

Outcomes Costs Service use

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How the sausage is made

For each participant:

What is the change in outcome? What are the costs of achieving this outcome?

Question: How much is an improved

  • utcome “worth”?

Putting the two together: Willingness to pay (WTP) and Net Benefit (NB) The crucial question: Does the intervention lead to a higher Net Benefit?

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NB = (WTP x outcome) - cost

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A simple example

Participant Change in BDI Costs WTP Net benefit Peter +5 £150 £0 (0*5)-150=-150 Paul

  • 3

£0 £0 (0*-3)-0=0 Mary +8 £250 £0 (0*8)-250=-250

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Simple example cont.

Participant Change in BDI Costs WTP Net benefit Peter +5 £150 £50 (50*5)-150=100 Paul

  • 3

£0 £50 (50*-3)-0=-150 Mary +8 £250 £50 (50*8)-250=150

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Simple example cont.

WTP Peter Paul Mary

  • 150
  • 250

25

  • 25
  • 75
  • 50

50 100

  • 150

150 75 225

  • 225

350 100 350

  • 300

550 250 1100

  • 750

1750 500 2350

  • 1500

3750 1000 4850

  • 3000

7750

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Quick recap:

For each participant:

What is the change in outcome? What are the costs of achieving this outcome?

Willingness to pay and Net Benefit Does the intervention lead to a higher Net Benefit?

Calculate probability that Net Benefit is higher in the intervention group (confidence!) Plot probability against WTP

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% £0 £20 £40 £60 £80 £100 £120 £140 £160 £180 £200 £220 £240 Probability that intervention is cost-effective Value placed on improved outcomes (WTP)

Beck Depression Inventory (BDI)

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% £0 £20 £40 £60 £80 £100 £120 £140 £160 £180 £200 £220 £240 Probability that intervention is cost-effective Value placed on improved outcomes (WTP)

Rosenberg Self-Esteem Scale (RSES)

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Conclusions

 Intervention relatively cheap at £161  No associated increase in support costs  Likely to be cost-effective in terms of reducing self-confidence problems and BDI, but willingness-to-pay not firmly established  Good option to engage people who receive little in terms of other support, despite high level of distress  An accessible, acceptable, (cost-)effective

  • ption to include within IAPT

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Thank you!

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% £0 £20 £40 £60 £80 £100 £120 £140 £160 £180 £200 £220 £240 Probability that intervention is cost-effective Willingness to pay

Beck Depression Inventory (BDI)

Insomnia Self-confidence

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% £0 £20 £40 £60 £80 £100 £120 £140 £160 £180 £200 £220 £240 Probability that intervention is cost-effective Willingness to pay

Specific outcome measures

Insomnia (ISI) Self-confidence (RSES)

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% £0k £5k £10k £15k £20k £25k £30k Probability that intervention is cost-effective Willingness to pay

Quality-adjusted life years (QALYs)

Insomnia Self-confidence