Article

OBJECTIVE: To evaluate the cost effectiveness of a psychological adjustment group
shown to be clinically effective in comparison with usual care for people with
multiple sclerosis. DESIGN: Randomized controlled trial with comparison of costs
and calculation of incremental cost effectiveness ratio. SETTING: Community.
PARTICIPANTS: People with multiple sclerosis were screened on the General Health
Questionnaire 12 and Hospital Anxiety and Depression Scale, and those with low
mood were recruited. INTERVENTIONS: Participants randomly allocated to the
adjustment group received six group treatment sessions. The control group
received usual care, which did not include psychological interventions. MAIN
MEASURES: Outcomes were assessed four and eight months after randomization, blind
to group allocation. The costs were assessed from a service use questionnaire and
information provided on medication. Quality of life was assessed using the EQ-5D.
RESULTS: Of the 311 patients identified, 221 (71%) met the criteria for having
low mood. Of these, 72 were randomly allocated to receive treatment and 79 to
usual care. Over eight months follow-up there was a decrease in the combined
average costs of pound378 per intervention respondent and an increase in the
costs of pound297 per patient in the control group, which was a significant
difference (p=0.03). The incremental cost-effectiveness ratio indicated that the
cost per point reduction on the Beck depression inventory-II was pound118.
CONCLUSION: In the short term, the adjustment group programme was cost effective
when compared with usual care, for people with multiple sclerosis presenting with
low mood. The longer-term costs need to be assessed.

Langue : ANGLAIS