Evidence map›Paper›PMID 30309835›Full record

Trial reportJournal of medical Internet research2018

Tailored, Therapist-Guided Internet-Based Cognitive Behavioral Therapy Compared to Care as Usual for Patients With Rheumatoid Arthritis: Economic Evaluation of a Randomized Controlled Trial.

Maaike Ferwerda, Sylvia van Beugen, Henriët van Middendorp, Henk Visser, Harald Vonkeman, Marjonne Creemers, Piet van Riel, Wietske Kievit, Andrea Evers

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of medical Internet research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 4 pooled it
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 4 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Maaike FerwerdaHealth, Medical and Neuropsychology Department, Institute of Psychology, Leiden University, Leiden, Netherlands.ORCID 0000-0003-4204-5795
Sylvia van BeugenHealth, Medical and Neuropsychology Department, Institute of Psychology, Leiden University, Leiden, Netherlands.ORCID 0000-0001-8220-1807
Henriët van MiddendorpHealth, Medical and Neuropsychology Department, Institute of Psychology, Leiden University, Leiden, Netherlands.ORCID 0000-0003-4575-0895
Henk VisserDepartment of Rheumatology, Rijnstate Hospital, Arnhem, Netherlands.ORCID 0000-0002-6873-1753
Harald VonkemanUniversity of Twente, Enschede, Netherlands.ORCID 0000-0003-3792-7718
Marjonne CreemersDepartment of Rheumatology, Jeroen Bosch Hospital, Den Bosch, Netherlands.ORCID 0000-0001-9110-1306
Piet van RielScientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, Netherlands.ORCID 0000-0001-7719-8906
Wietske KievitDepartment for Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands.ORCID 0000-0002-3984-1769
Andrea EversHealth, Medical and Neuropsychology Department, Institute of Psychology, Leiden University, Leiden, Netherlands.ORCID 0000-0002-0090-5091
Leiden University · NLRadboud University Nijmegen · NLJeroen Bosch Ziekenhuis · NLMedisch Spectrum Twente · NLRijnstate Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInternet-based cognitive behavioral therapy can aid patients with rheumatoid arthritis with elevated levels of distress to enhance their quality of life. However, implementation is currently lacking and there is little evidence available on the (cost-) effectiveness of different treatment strategies.

objectiveCost-benefit ratios are necessary for informing stakeholders and motivating them to implement effective treatment strategies for improving health-related quality of life (HRQoL) of patients with rheumatoid arthritis. A cost-effectiveness study from a societal perspective was conducted alongside a randomized controlled trial on a tailored, therapist-guided internet-based cognitive behavioral therapy (ICBT) intervention for patients with rheumatoid arthritis with elevated levels of distress as an addition to care as usual (CAU).

methodsData were collected at baseline or preintervention, 6 months or postintervention, and every 3 months thereafter during the 1-year follow-up. Effects were measured in terms of quality-adjusted life years (QALYs) and costs from a societal perspective, including health care sector costs (health care use, medication, and intervention costs), patient travel costs for health care use, and costs associated with loss of labor.

resultsThe intervention improved the quality of life compared with only CAU (Δ QALYs=0.059), but at a higher cost (Δ=€4211). However, this increased cost substantially reduced when medication costs were left out of the equation (Δ=€1863). Of all, 93% (930/1000) of the simulated incremental cost-effectiveness ratios were in the north-east quadrant, indicating a high probability that the intervention was effective in improving HRQoL, but at a greater monetary cost for society compared with only CAU.

conclusionsA tailored and guided ICBT intervention as an addition to CAU for patients with rheumatoid arthritis with elevated levels of distress was effective in improving quality of life. Consequently, implementation of ICBT into standard health care for patients with rheumatoid arthritis is recommended. However, further studies on cost reductions in this population are warranted.

trial registrationNederlands Trial Register NTR2100; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2100 (Archived by WebCite at http://www.webcitation.org/724t9pvr2).

Indexed as

AdultAgedArthritis, RheumatoidCognitive Behavioral TherapyCost-Benefit AnalysisFemaleHumansInternetMaleMiddle AgedQuality of LifeTreatment Outcomecognitive behavioral treatmentcost-utility analysisInternet-based therapyrheumatoid arthritis

Identifiers

PMID30309835
PMCPMC6231867
OpenAlexW2801391995

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.