Economic Evaluation of an Internet-Based Stress Management Intervention Alongside a Randomized Controlled Trial.
clinical trials, randomized
economic evaluation
internet
occupational stress
quality of life
work
Journal
JMIR mental health
ISSN: 2368-7959
Titre abrégé: JMIR Ment Health
Pays: Canada
ID NLM: 101658926
Informations de publication
Date de publication:
15 May 2019
15 May 2019
Historique:
received:
04
05
2018
accepted:
30
12
2018
revised:
02
11
2018
entrez:
17
5
2019
pubmed:
17
5
2019
medline:
17
5
2019
Statut:
epublish
Résumé
Work-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant. The aim of this study was to assess the cost-effectiveness of a guided iSMI for employees. A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale≥22) was assigned to either the iSMI or a waitlist control condition (WLC) with unrestricted access to treatment as usual. Participants were recruited in Germany in 2013 and followed through 2014, and data were analyzed in 2017. The iSMI consisted of 7 sessions plus 1 booster session. It was based on problem-solving therapy and emotion regulation techniques. Costs were measured from the societal perspective, including all direct and indirect medical costs. We performed a cost-effectiveness analysis and a cost-utility analysis relating costs to a symptom-free person and quality-adjusted life years (QALYs) gained, respectively. Sampling uncertainty was handled using nonparametric bootstrapping (N=5000). When the society is not willing to pay anything to get an additional symptom-free person (eg, willingness-to-pay [WTP]=€0), there was a 70% probability that the intervention is more cost-effective than WLC. This probability rose to 85% and 93% when the society is willing to pay €1000 and €2000, respectively, for achieving an additional symptom-free person. The cost-utility analysis yielded a 76% probability that the intervention is more cost-effective than WLC at a conservative WTP threshold of €20,000 (US $25,800) per QALY gained. Offering an iSMI to stressed employees has an acceptable likelihood of being cost-effective compared with WLC. German Clinical Trials Register DRKS00004749; https://www.drks.de/DRKS00004749. RR2-10.1186/1471-2458-13-655.
Sections du résumé
BACKGROUND
BACKGROUND
Work-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant.
OBJECTIVE
OBJECTIVE
The aim of this study was to assess the cost-effectiveness of a guided iSMI for employees.
METHODS
METHODS
A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale≥22) was assigned to either the iSMI or a waitlist control condition (WLC) with unrestricted access to treatment as usual. Participants were recruited in Germany in 2013 and followed through 2014, and data were analyzed in 2017. The iSMI consisted of 7 sessions plus 1 booster session. It was based on problem-solving therapy and emotion regulation techniques. Costs were measured from the societal perspective, including all direct and indirect medical costs. We performed a cost-effectiveness analysis and a cost-utility analysis relating costs to a symptom-free person and quality-adjusted life years (QALYs) gained, respectively. Sampling uncertainty was handled using nonparametric bootstrapping (N=5000).
RESULTS
RESULTS
When the society is not willing to pay anything to get an additional symptom-free person (eg, willingness-to-pay [WTP]=€0), there was a 70% probability that the intervention is more cost-effective than WLC. This probability rose to 85% and 93% when the society is willing to pay €1000 and €2000, respectively, for achieving an additional symptom-free person. The cost-utility analysis yielded a 76% probability that the intervention is more cost-effective than WLC at a conservative WTP threshold of €20,000 (US $25,800) per QALY gained.
CONCLUSIONS
CONCLUSIONS
Offering an iSMI to stressed employees has an acceptable likelihood of being cost-effective compared with WLC.
TRIAL REGISTRATION
BACKGROUND
German Clinical Trials Register DRKS00004749; https://www.drks.de/DRKS00004749.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
UNASSIGNED
RR2-10.1186/1471-2458-13-655.
Identifiants
pubmed: 31094355
pii: v6i5e10866
doi: 10.2196/10866
pmc: PMC6707573
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e10866Informations de copyright
©Fanny Kählke, Claudia Buntrock, Filip Smit, Matthias Berking, Dirk Lehr, Elena Heber, Burkhardt Funk, Heleen Riper, David Daniel Ebert. Originally published in JMIR Mental Health (http://mental.jmir.org), 15.05.2019.
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