Reducing suicidal ideation via the internet: Cost-effectiveness analysis alongside a randomised trial into unguided self-help
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van Spijker, Bregje; Majo, Cristina; Smit, Filip; van Straten, Annemieke; Kerkhof, Ad
Description
Background: Suicidal ideation is highly prevalent, but often remains untreated. The Internet can be used to provide accessible interventions. Objective: To evaluate the cost-effectiveness of an online, unguided, self-help intervention for reducing suicidal ideation. Methods: A total of 236 adults with mild to moderate suicidal thoughts, defined as scores between 1-26 on the Beck Scale for Suicide Ideation (BSS), were recruited in the general population and randomized to the intervention (n =...[Show more]
dc.contributor.author | van Spijker, Bregje | |
---|---|---|
dc.contributor.author | Majo, Cristina | |
dc.contributor.author | Smit, Filip | |
dc.contributor.author | van Straten, Annemieke | |
dc.contributor.author | Kerkhof, Ad | |
dc.date.accessioned | 2015-12-07T22:14:23Z | |
dc.identifier.issn | 1438-8871 | |
dc.identifier.uri | http://hdl.handle.net/1885/17394 | |
dc.description.abstract | Background: Suicidal ideation is highly prevalent, but often remains untreated. The Internet can be used to provide accessible interventions. Objective: To evaluate the cost-effectiveness of an online, unguided, self-help intervention for reducing suicidal ideation. Methods: A total of 236 adults with mild to moderate suicidal thoughts, defined as scores between 1-26 on the Beck Scale for Suicide Ideation (BSS), were recruited in the general population and randomized to the intervention (n = 116) or to a waitlist, information-only, control group (n = 120). The intervention aimed to decrease the frequency and intensity of suicidal ideation and consisted of 6 modules based on cognitive behavioral techniques. Participants in both groups had unrestricted access to care as usual. Assessments took place at baseline and 6 weeks later (post-test). All questionnaires were self-report and administered via the Internet. Treatment response was defined as a clinically significant decrease in suicidal ideation on the BSS. Total per-participant costs encompassed costs of health service uptake, participants' out-of-pocket expenses, costs stemming from production losses, and intervention costs. These were expressed in Euros (€) for the reference year 2009. Results: At post-test, treatment response was 35.3% and 20.8% in the experimental and control conditions, respectively. The incremental effectiveness was 0.35 - 0.21 = 0.15 (SE 0.06, P = .01). The annualized incremental costs were -€5039 per participant. Therefore, the mean incremental cost-effectiveness ratio (ICER) was estimated to be -€5039/0.15 = -€34,727 after rounding (US -$41,325) for an additional treatment response, indicating annual cost savings per treatment responder. Conclusions: This is the first trial to indicate that online self-help to reduce suicidal ideation is feasible, effective, and cost saving. Limitations included reliance on self-report and a short timeframe (6 weeks). Therefore, replication with a longer follow-up period is recommended. | |
dc.publisher | Journal of medical Internet Research | |
dc.source | Journal of Medical Internet Research | |
dc.subject | Keywords: adult; article; controlled clinical trial; controlled study; cost benefit analysis; female; human; Internet; male; Netherlands; questionnaire; randomized controlled trial; suicidal ideation; Adult; Cost-Benefit Analysis; Female; Humans; Internet; Male; Ne Cognitive behavior therapy; Cost-effectiveness; Internet; Randomized controlled trial; Suicidal ideation | |
dc.title | Reducing suicidal ideation via the internet: Cost-effectiveness analysis alongside a randomised trial into unguided self-help | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 14 | |
dc.date.issued | 2012 | |
local.identifier.absfor | 111700 - PUBLIC HEALTH AND HEALTH SERVICES | |
local.identifier.ariespublication | u5036076xPUB1 | |
local.type.status | Published Version | |
local.contributor.affiliation | van Spijker, Bregje, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | Majo, Cristina, Trimbos Institute, Netherlands Institute of Mental Health and Addiction | |
local.contributor.affiliation | Smit, Filip, Trimbos Institute, Netherlands Institute of Mental Health and Addiction | |
local.contributor.affiliation | van Straten, Annemieke, VU University | |
local.contributor.affiliation | Kerkhof, Ad, VU University Amsterdam | |
local.description.embargo | 2037-12-31 | |
local.bibliographicCitation.issue | 5 | |
local.bibliographicCitation.startpage | e141 | |
local.identifier.doi | 10.2196/jmir.1966 | |
dc.date.updated | 2016-02-24T11:33:49Z | |
local.identifier.scopusID | 2-s2.0-84872453506 | |
local.identifier.thomsonID | 000315108100023 | |
Collections | ANU Research Publications |
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