1. Cost-utility analysis of transcranial direct current stimulation (tDCS) in non-treatment-resistant depression: the DISCO randomised controlled study protocol
- Author
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Morgane Péré, Clémence Cabelguen, Luc Simons, Giordano D’Urso, Cécile Dert, Noémie Pineau, Thibault Deschamps, Réseau Hugopsy, Solène Schirr-Bonnans, Annabelle Rivalland, Samuel Bulteau, Valery-Pierre Riche, Nicolas Bukowski, Auxane Beslot, Lydie Lagalice, Jean-Marie Vanelle, Christelle Volteau, Marie Guitteny, Fabienne Tessier, Alison Robin, Adeline Lepage, Agathe Tostivint, Anne Sauvaget, Véronique Thomas-Ollivier, Motricité, interactions, performance EA 4334 / Movement - Interactions - Performance (MIP), Le Mans Université (UM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR des Sciences et Techniques des Activités Physiques et Sportives (UFR STAPS), Université de Nantes (UN)-Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, project PRME-17-0097, French Ministry of Health, CHU Pontchaillou [Rennes]-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-Institut des Neurosciences Cliniques de Rennes (INCR), Motricité, interaction, performance EA 4334 (MIP), Le Mans Université (UM)-Université de Nantes - UFR des Sciences et Techniques des Activités Physiques et Sportives (UFR STAPS), Institut des Neurosciences Cliniques de Rennes (INCR)-CHU Pontchaillou [Rennes]-Université européenne de Bretagne - European University of Brittany (UEB)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR)
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Cost-Benefit Analysis ,[SDV]Life Sciences [q-bio] ,Transcranial Direct Current Stimulation ,tDCS ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Health Economics ,Quality of life ,Medicine ,Humans ,Prospective Studies ,cost-utility ,Suicidal ideation ,Depression (differential diagnoses) ,ComputingMilieux_MISCELLANEOUS ,Protocol (science) ,Cost–utility analysis ,Transcranial direct-current stimulation ,treatment ,business.industry ,Depression ,General Medicine ,medicine.disease ,3. Good health ,030227 psychiatry ,England ,quality of life ,depression & mood disorders ,Physical therapy ,Female ,Quality-Adjusted Life Years ,medicine.symptom ,business ,Treatment-resistant depression ,030217 neurology & neurosurgery ,Follow-Up Studies ,study protocol - Abstract
IntroductionDepression is among the most widespread psychiatric disorders in France. Psychiatric disorders are associated with considerable social costs, amounting to €22.6 billion for treatment and psychotropic medication in 2011. Treatment as usual (TAU), mainly consisting of pharmacotherapy and psychotherapy, is effective for only a third of patients and in most cases fails to prevent treatment resistance and chronicity. Transcranial direct current stimulation (tDCS) consists in a non-invasive and painless application of low-intensity electric current to the cerebral cortex through the scalp. Having proved effective in depressed patients, it could be used in combination with TAU to great advantage. The objective is to compare, for the first time ever, the cost-utility of tDCS-TAU and of TAU alone for the treatment of a depressive episode that has been refractory to one or two drug treatments.Methods and analysisThis paper, based on the DISCO study protocol, focuses on the design of a prospective, randomised, controlled, open-label multicentre economic study to be conducted in France. It will include 214 patients with unipolar or bipolar depression, assigning them to two parallel arms: group A (tDCS-TAU) and group B (TAU alone). The primary outcome is the incremental cost-effectiveness ratio, that is, the ratio of the difference in cost between each strategy to the difference in their effects. Their effects will be expressed as numbers of quality-adjusted life-years, determined through administration of the EuroQol Five-Dimension questionnaire over a 12-month period to patients (EQ-5D-5L). Expected benefits are the reduction of treatment resistance and suicidal ideation as well as social and professional costs of depression. Should depression-related costs fall significantly, tDCS might be considered an efficient treatment for depression.Ethics and disseminationThis protocol has been approved by a French ethics committee, the CPP-–Est IV (Comité de Protection des Personnes–Strasbourg). Data are to be published in peer-reviewed medical journals.Trial registration numberRCB 2018-A00474-51;NCT03758105
- Published
- 2020
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