Adaptive Pacing, Cognitive Behaviour Therapy, Graded Exercise, and Specialist Medical Care for Chronic Fatigue Syndrome A Cost-Effectiveness Analysis 英文参考文献.docVIP

AdaptivePacing,CognitiveBehaviourTherapy,Graded Exercise,andSpecialistMedicalCareforChronicFatigue Syndrome:ACost-EffectivenessAnalysis PaulMcCrone1*,MichaelSharpe2,TrudieChalder3,MartinKnapp1,4,AnthonyL.Johnson5,6 , KimberleyA.Goldsmith7,PeterD.White8 1 Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King’s College London, London, United Kingdom,2 University Department of Psychiatry, University of Oxford, Oxford, United Kingdom,3 Academic Department of Psychological Medicine, King’s College London, London, United Kingdom,4 Personal Social Services Research Unit, London School of Economics, London, United Kingdom,5 MRC Biostatistics Unit, Institute of Public Health, Cambridge, United Kingdom,6 MRC Clinical Trials Unit, London, United Kingdom,7 Biostatistics Department, Institute of Psychiatry, King’s College London, London, United Kingdom, 8 Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom Abstract Background: The PACE trial compared the effectiveness of adding adaptive pacing therapy (APT), cognitive behaviour therapy (CBT), or graded exercise therapy (GET), to specialist medical care (SMC) for patients with chronic fatigue syndrome. This paper reports the relative cost-effectiveness of these treatments in terms of quality adjusted life years (QALYs) and improvements in fatigue and physical function. Methods: Resource use was measured and costs calculated. Healthcare and societal costs (healthcare plus lost production and unpaid informal care) were combined with QALYs gained, and changes in fatigue and disability; incremental cost- effectiveness ratios (ICERs) were computed. Results: SMC patients had significantly lower healthcare costs than