Mindfulness-based cognitive therapy <i>v</i>. treatment as usual in adults with ADHD: a multicentre, single-blind, randomised controlled trial

Janssen, Lotte; Kan, Cornelis C.; Carpentier, Pieter-Jan; Sizoo, Bram; Hepark, Sevket; Schellekens, Melanie P. J.; Donders, A. Rogier T.; Buitelaar, Jan K.; Speckens, Anne E. M.

doi:10.1017/s0033291718000429

Cited by 54 publications

(94 citation statements)

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“…For more methodological details, see the published protocol (Janssen et al 2015). The study had a time horizon of 9 months, from baseline till 6-months follow-up after posttreatment (Janssen et al 2018).…”

Section: Methodsmentioning

confidence: 99%

“…MBCT was taught in groups with approximately nine patients per group by four different mindfulness teachers, who all met the advanced criteria of the internationally agreed good practice guidelines of the UK Network for mindfulnessbased teachers (http://mindfulnessteachersuk.org.uk/pdf/ teacher-guidelines-2015.pdf). The competence levels of the four teachers were advanced (taught nine participants), competent (taught 21 participants), advanced beginner (taught 22 participants) and beginner (taught six participants) (Janssen et al 2018) based on the mindfulnessbased interventions-teaching assessment criteria (MBI: TAC; Crane et al 2012).…”

Section: Methodsmentioning

confidence: 99%

“…Patients in the TAU condition received the usual treatments for adult ADHD, consisting of pharmacotherapy and/or psychosocial treatments such as psychoeducation and skills training, except MBIs (Janssen et al 2018). Patients were free to start, continue, and stop a treatment as desired.…”

Section: Methodsmentioning

confidence: 99%

“…TAU was monitored during the study period. For a precise description of the received TAU in the period T0 to T1, see the RCT paper (Janssen et al 2018).…”

Section: Methodsmentioning

confidence: 99%

“…A recent multicenter, single-blind, randomized controlled trial (RCT) has demonstrated that mindfulness-based cognitive therapy (MBCT) is effective in reducing clinicianrated core symptoms (d = 0.41) in adults with ADHD compared to treatment as usual (TAU), an effect which was maintained at 6-month follow-up (d = 0.43). More patients in the MBCT + TAU group (31%) than in TAU (5%) showed a clinical reliable improvement of ADHD symptoms (Janssen et al 2018). However, it is unknown to what extent these clinical benefits in symptomatology outweigh the costs from a societal perspective, including health care costs and costs for productivity loss, and a health care perspective, including only medical costs.…”

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confidence: 99%

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Mindfulness-Based Cognitive Therapy Versus Treatment as Usual in Adults with ADHD: a Trial-Based Economic Evaluation

et al. 2019

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Objectives ADHD has a considerable economic impact. The aim of this study is to conduct a trial-based economic evaluation of mindfulness-based cognitive therapy (MBCT) added to treatment as usual (TAU) versus TAU in adults with ADHD. Methods A Dutch economic evaluation with a time horizon of 9 months was conducted from the societal perspective in the intention-to-treat (ITT) sample. Costs were assessed with a self-report questionnaire. Outcomes were expressed in quality adjusted life years (QALYs) and response rate. Bootstrap simulations were performed to estimate mean costs, QALYs, response rate, incremental cost-effectiveness ratios (ICERs), and associated uncertainty. Additional sensitivity analyses were done with imputed data, without extreme cost outliers, using the per protocol sample, and from a health care perspective. Results In the ITT sample, societal costs were €3572 for MBCT + TAU (n = 47; 95% CI 2416 to 4995) and €3389 for TAU (n = 49; 2327 to 4763). Average QALYs were 0.542 (0.522 to 0.563) per patient for MBCT + TAU and 0.534 (0.511 to 0.556) for TAU. In MBCT + TAU, more patients responded than in TAU (31% versus 6%; M bootstrapped difference 25%, 12 to 40%). ICERs were €21,963 per QALY gained and €389 per responder. At a threshold of €30,000 per QALY, the probability of MBCT being cost-effective was 51%. All sensitivity analyses showed more favorable results for MBCT + TAU. Conclusions In most analyses, MBCT was found to be more costly and effective, particularly in terms of disease-specific outcome, than TAU. If the threshold exceeds €30,000 per QALY and €1000 per responder, MBCT seemed cost-effective in treating adult ADHD. Keywords Adult ADHD. Mindfulness-based cognitive therapy. Cost-effectiveness. Health economy. Quality of life Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with an estimated prevalence of 2.5% at adult age (Simon et al. 2009). Its core symptoms affect academic, professional, and social functioning (Karlsdotter et al. 2016), and have a considerable personal and economic impact. A systematic review of Doshi et al. (2012) showed that in the USA, the estimates of overall annual incremental (excess)

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…TAU was monitored during the study period. For a precise description of the received TAU in the period T0 to T1, see the RCT paper (Janssen et al 2018).…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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