Cost‐utility analysis of meaning‐centered group psychotherapy for cancer survivors

Abstract

BackgroundMeaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors (MCGP-CS) was designed to help patients to sustain or enhance a sense of meaning and purpose in their lives. The aim of the proposed study is to evaluate the effectiveness and cost-effectiveness of MCGP-CS.Methods/DesignSurvivors diagnosed with cancer in the last 5 years and treated with curative intent, are recruited via several hospitals in the Netherlands. After screening, 168 survivors are randomly assigned to one of the three study arms: 1. Meaning-Centered Group Psychotherapy (MCGP-CS) 2. Supportive group psychotherapy (SGP) 3. Care as usual (CAU). Baseline assessment takes place before randomisation, with follow up assessments post-intervention and at 3, 6 and 12 months follow-up. Primary outcome is meaning making (PMP, PTGI, SPWB). Secondary outcome measures address quality of life (EORTC-30), anxiety and depression (HADS), hopelessness (BHS), optimism (LOT-R), adjustment to cancer (MAC), and costs (TIC-P, EQ-5D, PRODISQ).DiscussionMeaning-focused coping is key to adjustment to life after cancer, however, there is a lack of evidence based psychological interventions in this area. Many cancer survivors experience feelings of loneliness and alienation, and have a need for peer support, therefore a group method in particular, can be beneficial for sustaining or enhancing a sense of meaning. If this MCGP-CS is effective for cancer survivors, it can be implemented in the practice of psycho-oncology care.Trial registrationNetherlands Trial Register, NTR3571

Cost‐effectiveness analysis of telephone‐based cognitive behaviour therapy compared to treatment as usual CBT for cancer patients: Evidence from a small, randomised controlled trial

“…1 Data from this equivalence RCT indicated that T-CBT was of equivalent effectiveness to gold standard face-to-face Treatment as Usual CBT (TAU-CBT) in terms of patient reported psychological symptoms and benefits. Data on economic aspects of psychological interventions within oncology care remain sparse, however, [2][3][4][5] and require further investigation. While T-CBT and TAU-CBT are both of proven effectiveness in reducing psychological morbidity, the question arises of whether important cost implications exist both in terms of one therapy model compared to another, but also for the healthcare sector more broadly.…”

Long‐term efficacy of meaning‐centered group psychotherapy for cancer survivors: 2‐Year follow‐up results of a randomized controlled trial

“…It is a brief intervention that is effective and cost-effective. 8,11 Some of its effects linger on for 1 or even 2 years.…”

“…MCGP-CS participants reported better positive relations (SPWB) at long term, but did not report that these relations became a stronger (13) 59 (12) 62 (16) 63 (13) 57 (14) 59 (15) 61 (14) 58 (13) 59 (17) 63 (12) 58 (11) .030* .011* Goal-orientedness 69 (20) 71 (17) 72 (17) 74 (20) 72 (16) 63 (23) 66 (17) 69 (18) 66 (18) 66 (20) 73 (17) 68 ( Corrected for baseline score.…”

“…5,[8][9][10] MCGP-CS is likely to be cost-effective as well. 11 In a randomized controlled trial (RCT) among advanced cancer patients, MCGP was more effective than supportive group psychotherapy (SGP) in improving quality of life, spiritual well-being, and reducing depression and hopelessness. These improvements were sustained during the 2-month follow-up period.…”

New challenges in psycho‐oncology: Economic evaluation of psychosocial services in cancer: Challenges and best practice recommendations

“…28 Among the few cost-utility studies of psychosocial services, the EQ-5D was used by Strong et al to evaluate nurse-delivered collaborative care for the management of depression, 29 Duarte et al who evaluated the cost-effectiveness of a collaborative care program for major depression, 15 and most recently by van der Spek et al who assessed the cost-effectiveness of meaningcentred group psychotherapy for cancer survivors. 30 Chatterton et al used the AQoL-8D in the economic evaluation of a psychological intervention for high distress cancer patients and caregivers. 31 Nevertheless, these instruments are generic (ie, not disease specific), and therefore, their ability to accurately measure HRQoL in cancer patients is questionable.…”