Cost-utility of a guided Internet-based intervention in comparison with attention only for people with HIV and depressive symptoms: A randomized controlled trial

Sanne van Luenen; Vivian Kraaij; Nadia Garnefski; Philip Spinhoven; M Elske van den Akker-van Marle

doi:10.1016/j.jpsychores.2019.01.012

Cost-utility of a guided Internet-based intervention in comparison with attention only for people with HIV and depressive symptoms: A randomized controlled trial

J Psychosom Res. 2019 Mar:118:34-40. doi: 10.1016/j.jpsychores.2019.01.012. Epub 2019 Jan 18.

Authors

Sanne van Luenen¹, Vivian Kraaij², Nadia Garnefski³, Philip Spinhoven⁴, M Elske van den Akker-van Marle⁵

Affiliations

¹ Institute of Psychology, Section of Clinical Psychology, Leiden University, Leiden, The Netherlands. Electronic address: S.van.luenen@fsw.leidenuniv.nl.
² Institute of Psychology, Section of Clinical Psychology, Leiden University, Leiden, The Netherlands. Electronic address: Kraaij@fsw.leidenuniv.nl.
³ Institute of Psychology, Section of Clinical Psychology, Leiden University, Leiden, The Netherlands. Electronic address: Garnefski@fsw.leidenuniv.nl.
⁴ Institute of Psychology, Section of Clinical Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: Spinhoven@fsw.leidenuniv.nl.
⁵ Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: M.E.van_den_Akker-van_Marle@lumc.nl.

PMID: 30782352
DOI: 10.1016/j.jpsychores.2019.01.012

Abstract

Objective: The aim of this study was to evaluate the cost-utility of a guided Internet-based intervention for people living with HIV and depressive symptoms, compared to attention only (control condition). It was previously found that the intervention was effective in decreasing depressive symptoms, compared to the control group.

Methods: This economic evaluation was conducted alongside a randomized controlled trial. The control group received attention only and was put on a waiting list. Quality adjusted life years were calculated over six months. The study was conducted from a societal perspective and included intervention costs, healthcare costs, and non-healthcare costs. Participants completed a pretest, a post-test after two to three months, and a second post-test after six months. Cost-utility acceptability curves were constructed and two sensitivity analyses were conducted.

Results: No differences between the intervention and the control group were found in quality adjusted life years and total societal costs. The results indicate that the intervention is likely to be cost-effective, compared to attention only. The findings of the sensitivity analyses point in the same direction.

Conclusion: More research with larger samples is necessary to confirm the findings. The outcomes of this study may inform policy makers to decide which interventions will be included in policies. The guided Internet intervention may improve psychological care for people living with HIV and depressive symptoms, against low costs.

Trial registration: Nederlands Trialregister NTR5407, September 11, 2015.

Keywords: Cost utility; Depression; Economic evaluation; HIV; Internet intervention; Quality of life.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cost-Benefit Analysis / methods*
Depression / economics*
Female
HIV Infections / economics*
Health Care Costs / trends*
Humans
Internet-Based Intervention / trends*
Male
Middle Aged