Cost-utility of an internet-based intervention with or without therapist support in comparison with a waiting list for individuals with eating disorder symptoms: a randomized controlled trial
Abstract
Objective: To investigate the cost-utility of the internet-based intervention Featback provided with different levels of therapist support, in comparison to a waiting list.
Method: This economic evaluation was conducted from a societal perspective and was part of a randomized controlled trial in which participants (N=354) with self-reported ED symptoms were randomized to: (1) 8 weeks of Featback, consisting of psychoeducation and a fully automated monitoring- and feedback system, (2) Featback with low-intensity (weekly) therapist support, (3) Featback with high-intensity (three times a week) therapist support, and (4) a waiting list. Participants were assessed at baseline, postintervention, and 3-month follow-up. Cost-utility acceptability curves were constructed.
Results: No significant differences between the study conditions were found regarding quality-adjusted life-years (P=0.55) and societal costs (P=0.45), although the mean costs per participant were lowest in the Featback condition with low-intensity therapist support (Euro1951), followed by Featback with high-intensity therapist support (Euro2032), Featback without therapist support (Euro2102), and the waiting list (Euro2582). Featback seemed to be cost-effective as compared to the waiting list. No clear preference was found for Featback with or without therapist support. Discussion: A fully automated Internet-based intervention for ED symptoms with no, low-, or high-intensity therapist support represented good value for money when compared to a waiting list. This finding may have important implications for clinical practice, as both the unguided- and guided intervention could allow for more efficient care and widespread dissemination, potentially increasing the accessibility and availability of mental health care services for individuals with ED symptoms.
