Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: a randomized controlled trial

Behav Res Ther. 2014 Aug;59:1-11. doi: 10.1016/j.brat.2014.05.007. Epub 2014 Jun 2.

Abstract

A significant proportion of the general population suffers from anxiety disorders, often with comorbid psychiatric conditions. Internet-delivered cognitive behavior therapy (ICBT) has been found to be a potent treatment for patients with specific psychiatric conditions. The aim of this trial was to investigate the effectiveness and cost-effectiveness of ICBT when tailoring the treatment to address comorbidities and preferences for primary-care patients with a principal anxiety disorder. One hundred participants were recruited through their primary-care contact and randomized to either treatment or an active control group. The treatment consisted of 7-10 weekly individually assigned modules guided by online therapists. At post-treatment, 46% of the treatment group had achieved clinically significant improvement on the primary outcome measure (CORE-OM) and between-group effect sizes ranged from d = 0.20 to 0.86, with a mean effect of d = 0.59. At one-year follow-up, within-group effect sizes varied between d = 0.53 to 1.00. Cost analysis showed significant reduction of total costs for the ICBT group, the results were maintained at one-year follow-up and the incremental cost-effectiveness ratio favored ICBT compared to control group. Individually tailored ICBT is an effective and cost-effective treatment for primary-care patients with anxiety disorders with or without comorbidities.

Trial registration: Clinicaltrials.gov: NCT01390168.

Keywords: Anxiety; Cognitive behavior therapy; Comorbidity; Cost-effectiveness; Depression; Internet-delivered cognitive behavior therapy; Primary care.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / economics
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / economics*
  • Cost-Benefit Analysis
  • Health Care Costs*
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Patient Compliance
  • Primary Health Care*
  • Quality of Life
  • Therapy, Computer-Assisted / economics*
  • Treatment Outcome
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT01390168