Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

Siriwardena, Aloysius Niroshan; Apekey, Tanefa; Tilling, Michelle; Harrison, Andrew; Dyas, Jane; Middleton, Hugh; Ørner, Roderick; Sach, Tracey; Dewey, Michael; Qureshi, Zubair M

doi:10.1186/1471-2296-10-9

Cited by 16 publications

(11 citation statements)

References 27 publications

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“…Simplified Personal Questionnaire (PQ). The PQ (Elliott, Mack, & Shapiro, 1999;Shapiro, 1961) is an outcome measure meant to assess changes in the problems that patients report when they seek treatment. The PQ items are generated in a pretreatment semistructured interview, where the patient reports a list of problems that motivated him or her to seek therapy.…”

Section: Patient-generated Outcome Measuresmentioning

confidence: 99%

Patient-Centered Assessment in Psychotherapy: A Review of Individualized Tools

Sales

Alves

2016

Clin Psychol Sci Pract

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There has been an increasing interest in patient‐centered assessment of psychological treatments. This article reviews the existing patient‐generated measures (PGMs) that have been used by clinicians and psychotherapy researchers to collect evaluation data from the patient perspective. A systematic review of literature was performed to identify PGMs in empirical studies between 1990 and 2014. Twenty tools were identified, of which three were designed to assess the outcome and 17 to assess the process of therapy. The characteristics of each are described and discussed, including psychometric data and evidence of clinical utility. This review helps professionals and researchers to implement the recommendation of health policies that advocate the importance of patient‐centered care.

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Section: Patient-generated Outcome Measuresmentioning

confidence: 99%

Patient-Centered Assessment in Psychotherapy: A Review of Individualized Tools

Sales

Alves

2016

Clin Psychol Sci Pract

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“…Understanding the relationship between sleep hygiene and sleepiness will widen the avenue into the therapy of sleep problems regardless of etiology. Recent literature suggests the role of nonpharmacological therapies is important in treating many sleep problems (Azad, Byszewski, Sarazin, McLean, & Koziarz, 2003;Chesson et al, 1999;Harsora & Kessmann, 2009;Hoch et al, 2001;Siriwardena et al, 2009;Stepanski & Wyatt, 2003;Weiss, Wasdell, Bomben, Rea, & Freeman, 2006;Wildschiodtz & Rasmussen, 1981). Further, clarifying the sleep hygienesleepiness relationship should be particularly useful in population groups where hours are long and/or unpredictable, such as resident doctors, shift work employees, IT and BPO professionals.…”

mentioning

confidence: 99%

Excessive Daytime Sleepiness, Sleep Hygiene, and Work Hours Among Medical Residents in India

Mastin

Siddalingaiah

Singh

et al. 2012

Journal of Tropical Psychology

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The purpose of this study was to examine the relationship between sleep hygiene, excessive daytime sleepiness and work hours among resident physicians in Chandigarh, India. Data were collected from 350 volunteering junior resident doctors and included sociodemographic variables, excessive daytime sleepiness (EDS) as measured by the Epworth Sleepiness Scale (ESS), sleep hygiene as measured by the Sleep Hygiene Index and hours worked. Almost half of the resident physicians studied reported a problem of EDS and maladaptive sleep hygiene practices. Physicians working more than 80 hours per week and physicians with more maladaptive sleep behaviours were much more likely to report EDS. The authors propose that sleep hygiene and number of hours slept should be considered as EDS prevention and treatment strategies, especially for physicians working less than 80 hours per week. The authors also propose that the most salient intervention for physicians working more than 80 hours per week is one of workplace advocacy, where the government is encouraged to adopt legally binding guidelines as seen in other countries.

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“…Other economic evaluation literature has focused on interventions designed to provide education to health care providers (). Often, these interventions have included training on specialty care services such as insomnia care (), smoking cessation (), and hypertension prevention and control () for PCPs. These studies have found that, relative to usual care, training yielded ICERs between $25 and $54,755 per life year gained.…”

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness of Training Rural Providers to Perform Joint Injections

Nelson

Battistone

Ashworth

et al. 2014

Arthritis Care & Research

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Objective. Community-based outpatient clinics (CBOCs) have been established by the Department of Veterans Affairs (VA) to provide primary care services to veterans living in remote and rural regions. The objective of this study was to evaluate the cost effectiveness of training rural primary care providers to perform knee injections in CBOCs, thereby avoiding referring the patient to an urban medical center for an injection by rheumatology or orthopedic specialists. Methods. We developed a decision-analysis model to compare costs and outcomes between rural providers who are trained to perform knee injections versus those who are not trained, therefore requiring a referral to a specialist to provide the injections. The model was run separately using costs from the perspective of the VA as well from the patient's perspective. The effectiveness outcome was quality-adjusted life years (QALYs). Probabilistic sensitivity analyses were performed using 10,000 second-order Monte Carlo simulations. Results. In our base-case analyses, the incremental cost-effectiveness ratio for trained rural providers was $21,190/ QALY using costs from the perspective of the VA and $205/QALY using costs from the patient's perspective. Training rural providers was cost effective in 74.4% and 93.6% of 10,000 Monte Carlo simulations at a willingness-to-pay threshold of $50,000/QALY from the perspectives of the VA and the patient, respectively. Conclusion. Training rural providers to perform knee injections for patients with knee pain secondary to osteoarthritis appears cost effective using the commonly used threshold of $50,000/QALY if more than 20 such patients per year are seen at rural primary care clinics. These results provide support for our ongoing efforts to implement such a training program.

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Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

Cited by 16 publications

References 27 publications

Patient-Centered Assessment in Psychotherapy: A Review of Individualized Tools

Patient-Centered Assessment in Psychotherapy: A Review of Individualized Tools

Excessive Daytime Sleepiness, Sleep Hygiene, and Work Hours Among Medical Residents in India

Cost Effectiveness of Training Rural Providers to Perform Joint Injections

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