Cost-utility analysis of the UPRIGHT intervention promoting resilience in adolescents
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Published:2023-03-17
Issue:1
Volume:23
Page:
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ISSN:1471-244X
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Container-title:BMC Psychiatry
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language:en
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Short-container-title:BMC Psychiatry
Author:
Mar JavierORCID, Larrañaga Igor, Ibarrondo Oliver, González-Pinto Ana, Hayas Carlota las, Fullaondo Ane, Izco-Basurko Irantzu, Alonso Jordi, Zorrilla Iñaki, Fernández-Sevillano Jessica, de Manuel Esteban, González Nerea, Mateo-Abad Maider, Martínez Patricia Pérez, Vergara Itziar, Gabrielli Silvia, Rizzi Silvia, Zwiefka Antoni, Krzyżanowski Dominik, Mazur Iwona, Jakubowska Luba, Poteralska Renata, Czyż Piotr, Andruszko Urszula, Błasiak Paweł, Krajewska Katarzyna, Pytlarz Grzegorz, Szczygieł-Grüdl Ilona, Hjemdal Odin, Morote Roxanna, Anyan Frederick, Gudmundsdottir Dora Gudrun, Karlsdottir Solveig, Knoop Hans Henrik, Ledertoug Mette Marie, Tidmand Louise, Olafsdottir Anna Sigridur, Arnfjord Unnur B., Jonsdottir Bryndis Jona,
Abstract
AbstractBackgroundAs mental health in adulthood is related to mental status during adolescence, school-based interventions have been proposed to improve resilience. The objective of this study was to build a simulation model representing the natural history of mental disorders in childhood, adolescence and youth to estimate the cost-effectiveness of the UPRIGHT school-based intervention in promoting resilience and mental health in adolescence.MethodsWe built a discrete event simulation model fed with real-world data (cumulative incidence disaggregated into eight clusters) from the Basque Health Service database (609,381 individuals) to calculate utilities (quality-adjusted life years [QALYs]) and costs for the general population in two scenarios (base case and intervention). The model translated changes in the wellbeing of adolescents into different risks of mental illnesses for a time horizon of 30 years.ResultsThe number of cases of anxiety was estimated to fall by 5,125 or 9,592 and those of depression by 1,269 and 2,165 if the effect of the intervention lasted 2 or 5 years respectively. From a healthcare system perspective, the intervention was cost-effective for all cases considered with incremental cost-utility ratios always lower than €10,000/QALY and dominant for some subgroups. The intervention was always dominant when including indirect and non-medical costs (societal perspective).ConclusionsAlthough the primary analysis of the trial did not did not detect significant differences, the UPRIGHT intervention promoting positive mental health was dominant in the economic evaluation from the societal perspective. Promoting resilience was more cost-effective in the most deprived group. Despite a lack of information about the spillover effect in some sectors, the economic evaluation framework developed principally for pharmacoeconomics can be applied to interventions to promote resilience in adolescents. As prevention of mental health disorders is even more necessary in the post-coronavirus disease-19 era, such evaluation is essential to assess whether investment in mental health promotion would be good value for money by avoiding costs for healthcare providers and other stakeholders.
Funder
European Union’s Horizon 2020 framework programme for research and innovation
Publisher
Springer Science and Business Media LLC
Subject
Psychiatry and Mental health
Reference55 articles.
1. Mesman E, Vreeker A, Hillegers M. Resilience and mental health in children and adolescents: an update of the recent literature and future directions. Curr Opin Psychiatry. 2021;34:586–92. 2. O’Neil A, Jacka FN, Quirk SE, Cocker F, Taylor CB, Oldenburg B, et al. A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control. BMC Psychiatry. 2015;15:15. 3. Wykes T, Haro JM, Belli SR, Obradors-Tarragó C, Arango C, Ayuso-Mateos JL, et al. Mental health research priorities for Europe. Lancet Psychiatry. 2015;2:1036–42. 4. Las Hayas C, Izco-Basurko I, Fullaondo A, Gabrielli S, Zwiefka A, Hjemdal O, et al. UPRIGHT, a resilience-based intervention to promote mental well-being in schools: study rationale and methodology for a European randomized controlled trial. BMC Public Health. 2019;19:1413. 5. Windle G. What is resilience? A review and concept analysis. Rev Clin Gerontol. 2011;21:152–69.
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