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Cost-effectiveness of early intervention in psychosis: systematic review
- Source :
- The British Journal of Psychiatry. 215:388-394
- Publication Year :
- 2019
- Publisher :
- Royal College of Psychiatrists, 2019.
-
Abstract
- BackgroundEarly intervention in psychosis (EIP) has been developed as an approach to improve the prognosis of people with psychotic disorders and it has been claimed to be a more efficient model of care. However, the evidence is not definitive and doubts have spread regard to the economic outcomes of EIP services amid the usually restricted mental health budget.AimsWe aimed to review the cost-effectiveness evidence of EIP services worldwide.MethodWe systematically reviewed the economic literature about EIP following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement guidelines. Studies were selected according to previously stated criteria and analysed with standardised critical appraisal tools for trial-based economic evaluations and modelling studies.ResultsA total of 16 studies were selected after applying the eligibility criteria. Most of them were economic evaluations alongside clinical trials. The overall evidence was consistent in the cost-effectiveness of EIP compared with standard care for first episode of psychosis and the Clinical High Risk for Psychosis paradigm. Such evidence was replicated among different health systems, but mainly in high-income countries. The methodological quality of such evidence, however, was moderate and heterogeneity was significant across the studies.ConclusionsThere is consistent evidence that the implementation of EIP services might be a cost-effective alternative across different health systems. Such evidence, nevertheless, derives from heterogeneous and sometimes methodologically flawed studies, reducing the certainty of such statement. More efforts must be done to rigorously assess the value of this intervention, before expanding it among systems where mental health budgets are more constrained.Declaration of interestNone.
- Subjects :
- First episode
medicine.medical_specialty
Cost effectiveness
Cost-Benefit Analysis
Mental health
030227 psychiatry
Early intervention in psychosis
Clinical trial
03 medical and health sciences
Psychiatry and Mental health
Critical appraisal
0302 clinical medicine
Systematic review
Psychotic Disorders
Early Medical Intervention
Intervention (counseling)
medicine
Humans
Psychology
Psychiatry
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14721465 and 00071250
- Volume :
- 215
- Database :
- OpenAIRE
- Journal :
- The British Journal of Psychiatry
- Accession number :
- edsair.doi.dedup.....9e49e2a3df4f1bed7787796896d3820e