Coste efectividad de la Terapia de Aceptación y Compromiso en fibromialgia – Artículo de investigación publicado en ‘The Journal of Pain’

Se ha publicado hace unos semanas en la revista ‘The Journal of pain’ el artículo  ‘Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study).’. Los autores son: Juan V. Luciano, Francesco D’Amico, Albert Feliu-Soler, Lance M. McCracken, Jaume Aguado, María T. Peñarrubia-María, Martin Knapp, Antoni Serrano-Blanco y Javier García-Campayo.

Las terapias de tercera generación como Mindfulness y ACT (Terapia de Aceptación y Compromiso) han demostrado que son eficaces en diferentes enfermedades como depresión, ansiedad, dolor crónico (incluyendo fibromialgia), hipertensión, etc. Ahora, para que sean utilizados de forma sistemática por los sistemas sanitarios públicos, es necesario demostrar que son también coste-efectivas. Este es uno de los primeros estudios a nivel internacional que demuestra que mindfulness y, sobre todo, la Terapia de Aceptación y Compromiso, es coste efectiva, es decir que su precio está justificable por los beneficios que produce, en el caso de la fibromialgia. Esperamos que este articulo sirva para que los sistemas sanitarios se decidan a incluir esta terapia de forma gratuita.

 

Os facilitamos el abstract, ya que el artículo no puede descargarse a texto completo de forma gratuita. Si os interesa consultarlo y descargarlo podríais hacerlo en casi cualquier biblioteca universitaria, ya que es muy probable que estén suscritas a la revista ‘The Journal of Pain’, que es donde se ha publicado. 

Abstract

The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively. Analyses included Quality-Adjusted Life Years (QALYs), direct and indirect cost differences, and incremental cost-effectiveness ratios (ICERs). A total of 156 FM patients were randomized (51 GACT, 52 RPT, 53 WL). GACT was related to significantly less direct costs over the 6 month study period compared to both control arms (GACT €824.2 ± 1,062.7 vs. RPT €1,730.7 ± 1,656.8 vs WL €2,462.7 ± 2,822.0). Lower direct costs for GACT in comparison to RPT were due to lower costs from primary care visits and FM-related medications. The ICERs were dominant in the completers’ analysis and remained robust in the sensitivity analyses. In conclusion, ACT appears to be a cost-effective treatment in comparison to RPT in patients with FM.

PERSPECTIVE: 

Decision-makers have to prioritise their budget on the treatment option that is the most cost-effective for the management of a specific patient group. From both government and healthcare perspective, this study shows that a group-based form of Acceptance and Commitment Therapy is more cost-effective than pharmacological treatment in management of fibromyalgia.

 

Fotografía de Vanessa Bazzano, tomada de su galería en Flickr (Licencia de uso Creative Commons)

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