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Cost-utility of a psychoeducational intervention in fibromyalgia patients compared with usual care: an economic evaluation alongside a 12-month randomized controlled trial

Luciano, J. V., Sabes-Figuera, R., Cardeñosa, E., Peñarrubia-María, M. T., Fernández-Vergel, R., García-Campayo, J., Knapp, M. and Serrano-Blanco, A. (2013) Cost-utility of a psychoeducational intervention in fibromyalgia patients compared with usual care: an economic evaluation alongside a 12-month randomized controlled trial. Clinical Journal of Pain, 29 (8). pp. 702-711. ISSN 0749-8047

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Abstract

Objective: To determine the effectiveness of adding psychoeducational treatment implemented in general practice to usual care for patients with fibromyalgia (FM), and to analyze the cost-utility of the intervention from health care and societal perspectives. Methods: Twelve-month randomized controlled trial. A total of 216 primary care patients meeting the American College of Rheumatology criteria for FM participated in the study. The intervention included 9, 2-hour sessions of psychoeducation (5 sessions of education about the illness + 4 sessions of autogenic relaxation) added to usual care provided by a multidisciplinary group in general practice was compared to usual care in the public health system. Results: At 12-month follow-up, patients who received psychoeducation showed greater improvement in global functional status (Cohen d = 0.36; -2.49 to 3.81), physical functioning (Cohen d = 0.56; 0.08 to 1.00), days feeling well (Cohen d = 0.40; -0.16 to 1.02), pain (Cohen d = 0.35; -0.04 to 0.80), morning fatigue (Cohen d = 0.24; -0.20 to 0.76), stiffness (Cohen d = 0.34; -0.10 to 0.87), and depression (Cohen d = 0.30; -0.26 to 0.93). Mean incremental cost per person receiving the intervention was €-215.49 (-615.13 to 287.81) from the health care perspective, and €-197.32 (-785.12 to 395.74) from the societal perspective. The incremental gain in quality-adjusted life-years per person was 0.12 (0.06 to 0.19), yielding a "dominant" intervention from both perspectives. The sensitivity analysis suggested that the intervention was cost-effective even imputing all missing data. Discussion: Our findings demonstrate the long-term clinical effectiveness of a psychoeducational treatment program for FM implemented at primary care level and the cost-utility from a health care and societal perspective.

Item Type: Article
Official URL: http://journals.lww.com/clinicalpain/pages/default...
Additional Information: © 2013 Lippincott, Williams & Wilkins, Inc.
Library of Congress subject classification: H Social Sciences > HJ Public Finance
R Medicine > R Medicine (General)
Sets: Departments > Social Policy
Research centres and groups > Personal Social Services Research Unit (PSSRU)
Research centres and groups > LSE Health
Research centres and groups > NIHR School for Social Care Research
Rights: http://www.lse.ac.uk/library/usingTheLibrary/academicSupport/OA/depositYourResearch.aspx
Date Deposited: 02 Aug 2013 11:58
URL: http://eprints.lse.ac.uk/51356/

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