Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life

Anju Keetharuth; Rebecca  Gould; Christopher  McDermott; Benjamin Thompson; Charlotte Rawlinson; Mike Bradburn; Matt Bursnall; Pavithra Kumar; Emily Turton; Paul Tappenden; David White; Robert Howard; Marc Serfaty; Lance McCracken; Christopher  Graham; Ammar Al-Chalabi; Laura Goldstein; Vanessa Lawrence; Cindy Cooper; Tracy Young; COMMEND Collaboration Group

doi:10.1111/ene.16317

Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life

Anju Keetharuth, Rebecca Gould, Christopher McDermott, Benjamin Thompson, Charlotte Rawlinson, Mike Bradburn, Matt Bursnall, Pavithra Kumar, Emily Turton, Paul Tappenden, David White, Robert Howard, Marc Serfaty, Lance McCracken, Christopher Graham, Ammar Al-Chalabi, Laura Goldstein, Vanessa Lawrence, Cindy Cooper, Tracy YoungCOMMEND Collaboration Group

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost-effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life. Methods: A trial-based cost–utility analysis over a 9-month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality-adjusted life years (QALYs) were computed using health utilities generated from the EQ-5D-5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out. Results: Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ-5D-5L were not statistically significantly different between the two arms. The incremental cost-effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life-Revised (MQOL-R) questionnaire. The intervention was cost-effective in a subgroup experiencing medium deterioration in motor neuron symptoms. Conclusions: Despite the intervention being cost-ineffective in the primary analysis, the significant difference in the effects measured by MQOL-R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services.

Original language	English
Article number	e16317
Journal	European Journal of Neurology
Volume	31
Issue number	8
DOIs	https://doi.org/10.1111/ene.16317
Publication status	Published - 25 Apr 2024

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Keetharuth, A., Gould, R., McDermott, C., Thompson, B., Rawlinson, C., Bradburn, M., Bursnall, M., Kumar, P., Turton, E., Tappenden, P., White, D., Howard, R., Serfaty, M., McCracken, L., Graham, C., Al-Chalabi, A., Goldstein, L., Lawrence, V., Cooper, C., ... Collaboration Group, COMMEND. (2024). Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life. European Journal of Neurology, 31(8), Article e16317. https://doi.org/10.1111/ene.16317

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title = "Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life",

abstract = "Background: Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost-effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life. Methods: A trial-based cost–utility analysis over a 9-month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality-adjusted life years (QALYs) were computed using health utilities generated from the EQ-5D-5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out. Results: Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ-5D-5L were not statistically significantly different between the two arms. The incremental cost-effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life-Revised (MQOL-R) questionnaire. The intervention was cost-effective in a subgroup experiencing medium deterioration in motor neuron symptoms. Conclusions: Despite the intervention being cost-ineffective in the primary analysis, the significant difference in the effects measured by MQOL-R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services.",

author = "Anju Keetharuth and Rebecca Gould and Christopher McDermott and Benjamin Thompson and Charlotte Rawlinson and Mike Bradburn and Matt Bursnall and Pavithra Kumar and Emily Turton and Paul Tappenden and David White and Robert Howard and Marc Serfaty and Lance McCracken and Christopher Graham and Ammar Al-Chalabi and Laura Goldstein and Vanessa Lawrence and Cindy Cooper and Tracy Young and {Collaboration Group}, COMMEND",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.",

year = "2024",

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day = "25",

doi = "10.1111/ene.16317",

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Keetharuth, A, Gould, R, McDermott, C, Thompson, B, Rawlinson, C, Bradburn, M, Bursnall, M, Kumar, P, Turton, E, Tappenden, P, White, D, Howard, R, Serfaty, M, McCracken, L, Graham, C, Al-Chalabi, A , Goldstein, L , Lawrence, V, Cooper, C, Young, T & Collaboration Group, COMMEND 2024, 'Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life', European Journal of Neurology, vol. 31, no. 8, e16317. https://doi.org/10.1111/ene.16317

TY - JOUR

T1 - Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life

AU - Keetharuth, Anju

AU - Gould, Rebecca

AU - McDermott, Christopher

AU - Thompson, Benjamin

AU - Rawlinson, Charlotte

AU - Bradburn, Mike

AU - Bursnall, Matt

AU - Kumar, Pavithra

AU - Turton, Emily

AU - Tappenden, Paul

AU - White, David

AU - Howard, Robert

AU - Serfaty, Marc

AU - McCracken, Lance

AU - Graham, Christopher

AU - Al-Chalabi, Ammar

AU - Goldstein, Laura

AU - Lawrence, Vanessa

AU - Cooper, Cindy

AU - Young, Tracy

AU - Collaboration Group, COMMEND

PY - 2024/4/25

Y1 - 2024/4/25

N2 - Background: Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost-effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life. Methods: A trial-based cost–utility analysis over a 9-month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality-adjusted life years (QALYs) were computed using health utilities generated from the EQ-5D-5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out. Results: Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ-5D-5L were not statistically significantly different between the two arms. The incremental cost-effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life-Revised (MQOL-R) questionnaire. The intervention was cost-effective in a subgroup experiencing medium deterioration in motor neuron symptoms. Conclusions: Despite the intervention being cost-ineffective in the primary analysis, the significant difference in the effects measured by MQOL-R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services.

AB - Background: Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost-effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life. Methods: A trial-based cost–utility analysis over a 9-month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality-adjusted life years (QALYs) were computed using health utilities generated from the EQ-5D-5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out. Results: Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ-5D-5L were not statistically significantly different between the two arms. The incremental cost-effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life-Revised (MQOL-R) questionnaire. The intervention was cost-effective in a subgroup experiencing medium deterioration in motor neuron symptoms. Conclusions: Despite the intervention being cost-ineffective in the primary analysis, the significant difference in the effects measured by MQOL-R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services.

UR - https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16317

UR - http://www.scopus.com/inward/record.url?scp=85191299777&partnerID=8YFLogxK

U2 - 10.1111/ene.16317

DO - 10.1111/ene.16317

M3 - Article

SN - 1351-5101

VL - 31

JO - European Journal of Neurology

JF - European Journal of Neurology

IS - 8

M1 - e16317

ER -

Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life

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