Cost-Utility of Attachment-Based Compassion Therapy (ABCT) and Mindfulness-Based Stress Reduction (MBSR) in the Management of Depressive, Anxious, and Adjustment Disorders in Mental Health Settings: Economic Evaluation Alongside a Randomized Controlled Trial
Francesco d’Amico, Jaime Navarrete, Jesus Montero-Marin, Eugenia Cardeñosa-Valera, Mayte Navarro‐gil, Adrián Pérez-aranda, Yolanda López-del-hoyo, Carlos Collado-Navarro, Javier García-campayo, Juan V Luciano
Mindfulness March 1, 2024 DOI: 10.1007/s12671-024-02319-4 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 90 |
| Population | Spanish patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology |
| Interventions | Attachment-based compassion therapy (ABCT) Mindfulness-Based Stress Reduction (MBSR) treatment-as-usual (TAU) |
| Duration | 8 weekly group sessions; 6-month follow-up |
| Measures | EQ-5D-3L, Client Service Receipt Inventory |
| Topics | Depression Meditation |
| Registration | NCT03425487 |
| Key findings | Both MBSR and ABCT were more efficient than TAU alone, but the differences were not statistically significant. MBSR produced slightly higher costs (€53.69) and effects (0.004 QALYs) than ABCT, with an ICUR of €13,422.50/QALY. Both interventions significantly reduced general practice visits compared with TAU. |
Abstract
Abstract Objectives The main objective of this paper was to examine the cost-utility of attachment-based compassion therapy (ABCT) compared to Mindfulness-Based Stress Reduction (MBSR) and treatment-as-usual (TAU) on patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs from a public healthcare system perspective.
Method: A 6-month randomized controlled trial was conducted. Ninety Spanish patients with mental disorders (depressive, anxious, or adjustment disorders) received 8 weekly group sessions of TAU + ABCT, TAU + MBSR, or TAU alone. Data collection took place at pre- and 6-month follow-up. Cost-utility of the two treatment groups (ABCT vs MBSR vs TAU) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory).
Results: Both MBSR and ABCT were more efficient than TAU alone, although the results did not reach statistical significance. Compared to ABCT, MBSR produced an increase both in terms of costs (€53.69, 95% CI [− 571.27 to 513.14]) and effects (0.004 QALYs, 95% CI [− 0.031 to 0.049]); ICUR = €13,422.50/QALY). Both interventions significantly reduced the number of visits to general practice compared to TAU.
Conclusions: This study has contributed to the evidence base of mindfulness- and compassion-based programs and provided promising information about the cost-utility of MBSR for patients with emotional disorders. However, the small sample size and short follow-up period limit the generalizability of the findings. Preregistration Clinicaltrials.gov; NCT03425487.