Clinical and cost-effectiveness of two ways of delivering guided self-help for people with an eating disorder: a multi-arm randomised controlled trial

Jenkins, P. ORCID: https://orcid.org/0000-0003-1673-2903, Luck, A., Violato, M., Robinson, C. and Fairburn, C. G. (2021) Clinical and cost-effectiveness of two ways of delivering guided self-help for people with an eating disorder: a multi-arm randomised controlled trial. International Journal of Eating Disorders, 54 (7). pp. 1224-1237. ISSN 0276-3478 doi: 10.1002/eat.23554

Abstract/Summary

Objective: Increasing the availability and accessibility of evidence-based treatments for eating disorders is an important goal. This study investigated the effectiveness and cost-effectiveness of guided self-help via face-to-face meetings (fGSH) and a more scalable method, providing support via email (eGSH). Method: A pragmatic, randomised controlled trial was conducted at three sites. Adults with binge-eating disorders were randomised to fGSH, eGSH, or a waiting list condition, each lasting 12 weeks. The primary outcome variable for clinical effectiveness was overall severity of eating psychopathology and, for cost-effectiveness, binge-free days, with explorative analyses using symptom abstinence. Costs were estimated from both a partial societal and healthcare provider perspective. Results: Sixty participants were included in each condition. Both forms of GSH were superior to the control condition in reducing eating psychopathology (IRR = -1.32 [95% CI -1.77, -0.87], p<0.0001; IRR = -1.62 [95% CI -2.25, -1.00], p<0.0001) and binge eating. Attrition was higher in eGSH. Probabilities that fGSH and eGSH were cost-effective compared with WL were 93% (99%) and 51% (79%), respectively, for a willingness to pay of £100 (£150) per additional binge-free day. Discussion: Both forms of GSH were associated with clinical improvement and were likely to be cost-effective compared with a waiting list condition. Provision of support via email is likely to be more convenient for many patients although the risk of non-completion is greater.

Item Type	Article
URI	https://reading-clone.eprints-hosting.org/id/eprint/97961
Identification Number/DOI	10.1002/eat.23554
Refereed	Yes
Divisions	Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology Life Sciences > School of Psychology and Clinical Language Sciences > Psychopathology and Affective Neuroscience
Publisher	Wiley
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