Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance

Research output: Contribution to journalArticle

Standard

Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance. / Radhakrishnan, Muralikrishnan; McCrone, Paul; Lafortune, Louise; Everard, Linda; Fowler, David; Amos, Tim; Freemantle, Nick; Singh, Swaran P.; Marshall, Max; Sharma, Vimal; Lavis, Anna; Jones, Peter B.; Birchwood, Max.

In: Early Intervention in Psychiatry, Vol. 12, No. 4, 01.08.2018, p. 747-756.

Research output: Contribution to journalArticle

Harvard

Radhakrishnan, M, McCrone, P, Lafortune, L, Everard, L, Fowler, D, Amos, T, Freemantle, N, Singh, SP, Marshall, M, Sharma, V, Lavis, A, Jones, PB & Birchwood, M 2018, 'Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance', Early Intervention in Psychiatry, vol. 12, no. 4, pp. 747-756. https://doi.org/10.1111/eip.12481

APA

Radhakrishnan, M., McCrone, P., Lafortune, L., Everard, L., Fowler, D., Amos, T., ... Birchwood, M. (2018). Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance. Early Intervention in Psychiatry, 12(4), 747-756. https://doi.org/10.1111/eip.12481

Vancouver

Author

Radhakrishnan, Muralikrishnan ; McCrone, Paul ; Lafortune, Louise ; Everard, Linda ; Fowler, David ; Amos, Tim ; Freemantle, Nick ; Singh, Swaran P. ; Marshall, Max ; Sharma, Vimal ; Lavis, Anna ; Jones, Peter B. ; Birchwood, Max. / Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance. In: Early Intervention in Psychiatry. 2018 ; Vol. 12, No. 4. pp. 747-756.

Bibtex

@article{86e992f210ce4bf6b4d88c50814b6510,
title = "Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance",
abstract = "AIM: Early intervention services (EIS) for psychosis are being implemented, internationally. It is important to learn from established examples and define the components and intensity of services that provide good value for money. This study aims to assess the cost-effectiveness of EIS according to how closely they adhered to the recommendations of the English Department of Health 2001 Policy Implementation Guide (PIG).METHODS: EIS from the National Eden Study were assessed using a measure of fidelity to the PIG that rated the presence or absence of 64 recommended items relating to team structure and practice. EIS were then classified into three groups: those with fidelity of 75-80{\%}, 81-90{\%} and 91-95{\%}. Patient-level resource use and outcomes were measured 1 year following inception into the service; costs were calculated and combined with quality-adjusted life years (QALYs) gained.RESULTS: At a threshold of £20 000 per QALY, the 81-90{\%} fidelity group had a 56.3{\%} likelihood of being the most cost-effective option followed by 75-80{\%} fidelity at 35.8{\%} and 91-95{\%} fidelity group (7.9{\%}).CONCLUSIONS: The results from England suggest that striving to maximize fidelity may not be warranted, but that dropping below a certain level of fidelity may result in inefficient use of resources.",
keywords = "psychotic disorders, early medical intervention, economic evaluation, quality adjusted life years, costs and cost analysis",
author = "Muralikrishnan Radhakrishnan and Paul McCrone and Louise Lafortune and Linda Everard and David Fowler and Tim Amos and Nick Freemantle and Singh, {Swaran P.} and Max Marshall and Vimal Sharma and Anna Lavis and Jones, {Peter B.} and Max Birchwood",
note = "{\circledC} 2017 John Wiley & Sons Australia, Ltd.",
year = "2018",
month = "8",
day = "1",
doi = "10.1111/eip.12481",
language = "English",
volume = "12",
pages = "747--756",
journal = "Early Intervention in Psychiatry",
issn = "1751-7885",
publisher = "Wiley",
number = "4",

}

RIS

TY - JOUR

T1 - Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance

AU - Radhakrishnan, Muralikrishnan

AU - McCrone, Paul

AU - Lafortune, Louise

AU - Everard, Linda

AU - Fowler, David

AU - Amos, Tim

AU - Freemantle, Nick

AU - Singh, Swaran P.

AU - Marshall, Max

AU - Sharma, Vimal

AU - Lavis, Anna

AU - Jones, Peter B.

AU - Birchwood, Max

N1 - © 2017 John Wiley & Sons Australia, Ltd.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - AIM: Early intervention services (EIS) for psychosis are being implemented, internationally. It is important to learn from established examples and define the components and intensity of services that provide good value for money. This study aims to assess the cost-effectiveness of EIS according to how closely they adhered to the recommendations of the English Department of Health 2001 Policy Implementation Guide (PIG).METHODS: EIS from the National Eden Study were assessed using a measure of fidelity to the PIG that rated the presence or absence of 64 recommended items relating to team structure and practice. EIS were then classified into three groups: those with fidelity of 75-80%, 81-90% and 91-95%. Patient-level resource use and outcomes were measured 1 year following inception into the service; costs were calculated and combined with quality-adjusted life years (QALYs) gained.RESULTS: At a threshold of £20 000 per QALY, the 81-90% fidelity group had a 56.3% likelihood of being the most cost-effective option followed by 75-80% fidelity at 35.8% and 91-95% fidelity group (7.9%).CONCLUSIONS: The results from England suggest that striving to maximize fidelity may not be warranted, but that dropping below a certain level of fidelity may result in inefficient use of resources.

AB - AIM: Early intervention services (EIS) for psychosis are being implemented, internationally. It is important to learn from established examples and define the components and intensity of services that provide good value for money. This study aims to assess the cost-effectiveness of EIS according to how closely they adhered to the recommendations of the English Department of Health 2001 Policy Implementation Guide (PIG).METHODS: EIS from the National Eden Study were assessed using a measure of fidelity to the PIG that rated the presence or absence of 64 recommended items relating to team structure and practice. EIS were then classified into three groups: those with fidelity of 75-80%, 81-90% and 91-95%. Patient-level resource use and outcomes were measured 1 year following inception into the service; costs were calculated and combined with quality-adjusted life years (QALYs) gained.RESULTS: At a threshold of £20 000 per QALY, the 81-90% fidelity group had a 56.3% likelihood of being the most cost-effective option followed by 75-80% fidelity at 35.8% and 91-95% fidelity group (7.9%).CONCLUSIONS: The results from England suggest that striving to maximize fidelity may not be warranted, but that dropping below a certain level of fidelity may result in inefficient use of resources.

KW - psychotic disorders

KW - early medical intervention

KW - economic evaluation

KW - quality adjusted life years

KW - costs and cost analysis

U2 - 10.1111/eip.12481

DO - 10.1111/eip.12481

M3 - Article

C2 - 28857431

VL - 12

SP - 747

EP - 756

JO - Early Intervention in Psychiatry

JF - Early Intervention in Psychiatry

SN - 1751-7885

IS - 4

ER -