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Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes: economic evaluation from a randomized controlled trial

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Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes : economic evaluation from a randomized controlled trial. / Patel, Anita; Maissi, E; Chang, H-C; Rodrigues, I; Smith, M; Thomas, Stephen; Chalder, T; Schmidt, U; Treasure, J; Ismail, K.

In: Diabetic Medicine, Vol. 28, No. 4, 04.2011, p. 470-479.

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Harvard

Patel, A, Maissi, E, Chang, H-C, Rodrigues, I, Smith, M, Thomas, S, Chalder, T, Schmidt, U, Treasure, J & Ismail, K 2011, 'Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes: economic evaluation from a randomized controlled trial', Diabetic Medicine, vol. 28, no. 4, pp. 470-479. https://doi.org/10.1111/j.1464-5491.2010.03198.x

APA

Patel, A., Maissi, E., Chang, H-C., Rodrigues, I., Smith, M., Thomas, S., ... Ismail, K. (2011). Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes: economic evaluation from a randomized controlled trial. Diabetic Medicine, 28(4), 470-479. https://doi.org/10.1111/j.1464-5491.2010.03198.x

Vancouver

Patel A, Maissi E, Chang H-C, Rodrigues I, Smith M, Thomas S et al. Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes: economic evaluation from a randomized controlled trial. Diabetic Medicine. 2011 Apr;28(4):470-479. https://doi.org/10.1111/j.1464-5491.2010.03198.x

Author

Patel, Anita ; Maissi, E ; Chang, H-C ; Rodrigues, I ; Smith, M ; Thomas, Stephen ; Chalder, T ; Schmidt, U ; Treasure, J ; Ismail, K. / Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes : economic evaluation from a randomized controlled trial. In: Diabetic Medicine. 2011 ; Vol. 28, No. 4. pp. 470-479.

Bibtex Download

@article{0d248c562a0d4a3ea38f4c6e025ecb41,
title = "Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes: economic evaluation from a randomized controlled trial",
abstract = "Aims:  To assess the cost-effectiveness of motivational enhancement therapy and cognitive behaviour therapy for poorly controlled Type 1 diabetes.Methods:  Within-trial prospective economic evaluation from (i) health and social care and (ii) societal perspectives. Three hundred and forty-four adults with Type 1 diabetes for at least 2 years and persistent, suboptimal glycaemic control were recruited to a three-arm multi-centre randomized controlled trial in London and Manchester, UK. They were randomized to (i) usual care plus four sessions of motivational enhancement therapy (ii) usual care plus four sessions of motivational enhancement therapy and eight sessions of cognitive behaviour therapy or (iii) usual care alone. Outcomes were (i) costs, (ii) Quality-Adjusted Life Year gains measured by the EuroQol 5-dimensional health state index and the 36-item Short Form and (iii) diabetes control measured by change in HbA1c level at 1 year.Results:  Both intervention groups had significantly higher mean health and social care costs (+ £535 for motivational enhancement therapy and + £790 for combined motivational enhancement and cognitive behavioural therapy ), but not societal costs compared with the usual-care group. There were no differences in Quality Adjusted Life Years. There was a significantly greater HbA1c improvement in the combined motivational enhancement and cognitive behavioural therapy group (+ 0.45{\%}; incremental cost-effectiveness ratio = £1756), but the not in the motivational enhancement therapy group. Cost-effectiveness acceptability curves suggested that both interventions had low probabilities of cost-effectiveness based on Quality Adjusted Life Years (but high based on HbA1c improvements). Imputing missing costs and outcomes confirmed these findings.Conclusions:  Neither therapy was undisputedly cost-effective compared with usual care alone, but conclusions vary depending on the relative importance of clinical and quality-of-life outcomes.",
keywords = "INTERVENTIONS, cost-effectiveness, UTILITY, SF-36, COST-EFFECTIVENESS ANALYSIS, diabetes, HEALTH, INTENSIVE THERAPY, psychological therapy, UK, cost, GLYCEMIC CONTROL",
author = "Anita Patel and E Maissi and H-C Chang and I Rodrigues and M Smith and Stephen Thomas and T Chalder and U Schmidt and J Treasure and K Ismail",
year = "2011",
month = "4",
doi = "10.1111/j.1464-5491.2010.03198.x",
language = "English",
volume = "28",
pages = "470--479",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "4",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Motivational enhancement therapy with and without cognitive behaviour therapy for Type 1 diabetes

T2 - economic evaluation from a randomized controlled trial

AU - Patel, Anita

AU - Maissi, E

AU - Chang, H-C

AU - Rodrigues, I

AU - Smith, M

AU - Thomas, Stephen

AU - Chalder, T

AU - Schmidt, U

AU - Treasure, J

AU - Ismail, K

PY - 2011/4

Y1 - 2011/4

N2 - Aims:  To assess the cost-effectiveness of motivational enhancement therapy and cognitive behaviour therapy for poorly controlled Type 1 diabetes.Methods:  Within-trial prospective economic evaluation from (i) health and social care and (ii) societal perspectives. Three hundred and forty-four adults with Type 1 diabetes for at least 2 years and persistent, suboptimal glycaemic control were recruited to a three-arm multi-centre randomized controlled trial in London and Manchester, UK. They were randomized to (i) usual care plus four sessions of motivational enhancement therapy (ii) usual care plus four sessions of motivational enhancement therapy and eight sessions of cognitive behaviour therapy or (iii) usual care alone. Outcomes were (i) costs, (ii) Quality-Adjusted Life Year gains measured by the EuroQol 5-dimensional health state index and the 36-item Short Form and (iii) diabetes control measured by change in HbA1c level at 1 year.Results:  Both intervention groups had significantly higher mean health and social care costs (+ £535 for motivational enhancement therapy and + £790 for combined motivational enhancement and cognitive behavioural therapy ), but not societal costs compared with the usual-care group. There were no differences in Quality Adjusted Life Years. There was a significantly greater HbA1c improvement in the combined motivational enhancement and cognitive behavioural therapy group (+ 0.45%; incremental cost-effectiveness ratio = £1756), but the not in the motivational enhancement therapy group. Cost-effectiveness acceptability curves suggested that both interventions had low probabilities of cost-effectiveness based on Quality Adjusted Life Years (but high based on HbA1c improvements). Imputing missing costs and outcomes confirmed these findings.Conclusions:  Neither therapy was undisputedly cost-effective compared with usual care alone, but conclusions vary depending on the relative importance of clinical and quality-of-life outcomes.

AB - Aims:  To assess the cost-effectiveness of motivational enhancement therapy and cognitive behaviour therapy for poorly controlled Type 1 diabetes.Methods:  Within-trial prospective economic evaluation from (i) health and social care and (ii) societal perspectives. Three hundred and forty-four adults with Type 1 diabetes for at least 2 years and persistent, suboptimal glycaemic control were recruited to a three-arm multi-centre randomized controlled trial in London and Manchester, UK. They were randomized to (i) usual care plus four sessions of motivational enhancement therapy (ii) usual care plus four sessions of motivational enhancement therapy and eight sessions of cognitive behaviour therapy or (iii) usual care alone. Outcomes were (i) costs, (ii) Quality-Adjusted Life Year gains measured by the EuroQol 5-dimensional health state index and the 36-item Short Form and (iii) diabetes control measured by change in HbA1c level at 1 year.Results:  Both intervention groups had significantly higher mean health and social care costs (+ £535 for motivational enhancement therapy and + £790 for combined motivational enhancement and cognitive behavioural therapy ), but not societal costs compared with the usual-care group. There were no differences in Quality Adjusted Life Years. There was a significantly greater HbA1c improvement in the combined motivational enhancement and cognitive behavioural therapy group (+ 0.45%; incremental cost-effectiveness ratio = £1756), but the not in the motivational enhancement therapy group. Cost-effectiveness acceptability curves suggested that both interventions had low probabilities of cost-effectiveness based on Quality Adjusted Life Years (but high based on HbA1c improvements). Imputing missing costs and outcomes confirmed these findings.Conclusions:  Neither therapy was undisputedly cost-effective compared with usual care alone, but conclusions vary depending on the relative importance of clinical and quality-of-life outcomes.

KW - INTERVENTIONS

KW - cost-effectiveness

KW - UTILITY

KW - SF-36

KW - COST-EFFECTIVENESS ANALYSIS

KW - diabetes

KW - HEALTH

KW - INTENSIVE THERAPY

KW - psychological therapy

KW - UK

KW - cost

KW - GLYCEMIC CONTROL

U2 - 10.1111/j.1464-5491.2010.03198.x

DO - 10.1111/j.1464-5491.2010.03198.x

M3 - Article

C2 - 21392068

VL - 28

SP - 470

EP - 479

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 4

ER -

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