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Cost-Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study)
Inst Recerca St Joan de Deu, Grp Psychol Res Fibromyalgia & Chron Pain AGORA, Esplugas de Llobregat 08950, Spain;Teaching Res & Innovat Unit, Parc Sanitari St Joan de Deu, St Boi De Llobregat 08830, Spain;RedIAPP, Primary Care Prevent & Hlth Promot Res Network, Madrid 28029, Spain;Univ Barcelona, Dept Clin Psychol & Psychobiol, Sect Personal Assessment & Psychol Treatments, Barcelona 08193, Spain.
London Sch Econ & Polit Sci LSE, London WC2A 2AE, England.
Inst Recerca St Joan de Deu, Grp Psychol Res Fibromyalgia & Chron Pain AGORA, Esplugas de Llobregat 08950, Spain;Teaching Res & Innovat Unit, Parc Sanitari St Joan de Deu, St Boi De Llobregat 08830, Spain;RedIAPP, Primary Care Prevent & Hlth Promot Res Network, Madrid 28029, Spain.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0002-9734-0153
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2019 (English)In: JOURNAL OF CLINICAL MEDICINE, ISSN 2077-0383, Vol. 8, no 7, article id 1068Article in journal (Refereed) Published
Abstract [en]

Fibromyalgia (FM) is a prevalent, chronic, disabling, pain syndrome that implies high healthcare costs. Economic evaluations of potentially effective treatments for FM are needed. The aim of this study was to analyze the cost-utility of Mindfulness-Based Stress Reduction (MBSR) as an add-on to treatment-as-usual (TAU) for patients with FM compared to an adjuvant multicomponent intervention (FibroQoL) and to TAU. We performed an economic evaluation alongside a 12 month, randomized, controlled trial; data from 204 (68 per study arm) of the 225 patients (90.1%) were included in the cost-utility analyses, which were conducted both under the government and the public healthcare system perspectives. The main outcome measures were the EuroQol (EQ-5D-5L) for assessing Quality-Adjusted Life Years (QALYs) and improvements in health-related quality of life, and the Client Service Receipt Inventory (CSRI) for estimating direct and indirect costs. Incremental cost-effectiveness ratios (ICERs) were also calculated. Two sensitivity analyses (intention-to-treat, ITT, and per protocol, PPA) were conducted. The results indicated that MBSR achieved a significant reduction in costs compared to the other study arms (p < 0.05 in the completers sample), especially in terms of indirect costs and primary healthcare services. It also produced a significant incremental effect compared to TAU in the ITT sample (Delta QALYs = 0.053, p < 0.05, where QALYs represents quality-adjusted life years). Overall, our findings support the efficiency of MBSR over FibroQoL and TAU specifically within a Spanish public healthcare context.

Place, publisher, year, edition, pages
MDPI , 2019. Vol. 8, no 7, article id 1068
Keywords [en]
fibromyalgia, cost-utility, cost-effectiveness, quality-adjusted life years
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:uu:diva-393136DOI: 10.3390/jcm8071068ISI: 000479003300150PubMedID: 31330832OAI: oai:DiVA.org:uu-393136DiVA, id: diva2:1353763
Available from: 2019-09-24 Created: 2019-09-24 Last updated: 2019-09-24Bibliographically approved

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