Predicting treatment outcomes of the Empowerment group intervention for refugees with affective disorders: Findings from the MEHIRA project

Strupf, Michael; Wiechers, Maren; Bajbouj, Malek; Böge, Kerem; Karnouk, Carine; Goerigk, Stephan; Kamp‐Becker, Inge; Banaschewski, Tobias; Rapp, Michael A.; Hasan, Alkomiet; Falkai, P.; Jobst-Heel, Andrea; Habel, Ute; Stamm, Thomas; Heinz, Andreas; Hoell, Andreas; Burger, Max; Bunse, T.; Hoehne, Edgar; Mehran, Nassim; Kaiser, Franziska; Hahn, Eric; Plener, Paul L.; Übleis, Aline; Padberg, Frank

doi:10.1016/j.jad.2022.11.050

Cited by 5 publications

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“…14 In addition, Empowerment proved to be effective in reducing depressive symptoms in RAS. 18,19 Cost-effectiveness analysis supported the hypothesis that Empowerment is cost-effective compared with TAU concerning the improvement of symptoms. There was an 87% probability of obtaining an additional effect without additional costs.…”

Section: Discussionmentioning

confidence: 82%

“…A detailed description of the trial, 15 the main publication on effectiveness and cost-effectiveness of the SCCM, 16 and intervention-specific evaluations of the effectiveness 18 and predictors of the Empowerment intervention 19 are available elsewhere.…”

Section: Methodsmentioning

confidence: 99%

“… 16 It did not include an in-depth evaluation of the single and innovative components currently not included in the reimbursement scheme of the mental healthcare system in Germany. There are first indications that Empowerment is an effective, stand-alone treatment for refugees 18 , 19 that could be delivered by multiple service providers with a range of qualifications in diverse settings, for instance, practising psychotherapists in out-patient care, social workers in refugee reception centres or mental health staff in in-patient psychiatry. Thus, an (explorative) analysis of the health economical parameters is of high relevance from both clinical and healthcare providers’ perspectives.…”

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confidence: 99%

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Shared sorrow, shared costs: cost-effectiveness analysis of the Empowerment group therapy approach to treat affective disorders in refugee populations

et al. 2023

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Background Refugees and asylum seekers (RAS) in Germany need tailored and resource-oriented mental healthcare interventions. Aims To evaluate the cost-effectiveness of group psychotherapy for RAS with moderate depressive symptoms. Method This is a post hoc cost-effectiveness analysis of Empowerment group psychotherapy that was embedded in a stratified stepped and collaborative care model (SCCM) from the multicentre randomised controlled MEHIRA trial. One hundred and forty-nine participants were randomly assigned to SCCM or treatment as usual (TAU) and underwent Empowerment (i.e. level 3 of the SCCM for adults) or TAU. Effects were measured with the nine-item Patient Health Questionnaire (PHQ-9) and quality adjusted life-years (QALY) post-intervention. Health service and intervention costs were measured. Incremental cost-effectiveness ratios (ICER) were estimated and net monetary benefit (NMB) regressions with 95% confidence intervals were performed. Cost-effectiveness was ascertained for different values of willingness to pay (WTP) using cost-effectiveness acceptability curves for probable scenarios. Trial registration number: NCT03109028 on ClinicalTrials.gov. Results Health service use costs were significantly lower for Empowerment than TAU after 1 year. Intervention costs were on average €409.6. Empowerment led to a significant change in PHQ-9 scores but not QALY. Bootstrapped mean ICER indicated cost-effectiveness according to PHQ-9 and varied considerably for QALY in the base case. NMB for a unit reduction in PHQ-9 score at WTP of €0 was €354.3 (€978.5 to −€269.9). Results were confirmed for different scenarios and varying WTP thresholds. Conclusions The Empowerment intervention was cost-effective in refugees with moderate depressive symptoms regarding the clinical outcome and led to a reduction in direct healthcare consumption. Concerning QALYs, there was a lack of confidence that Empowerment differed from TAU.

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Section: Discussionmentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Shared sorrow, shared costs: cost-effectiveness analysis of the Empowerment group therapy approach to treat affective disorders in refugee populations

et al. 2023

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“…Die Gruppenpsychotherapie Empowerment [14] wurde 2017 im Rahmen der multizentrischen Studie MEHIRA (Mental Health in Refugees and Asylum Seekers) an der Klinik für Psychiatrie und Psychotherapie der Universität München entwickelt und innerhalb eines gestuften Versorgungsmodells für Geflüchtete mit affektiven Erkrankungen implementiert [15,16]. In einer Stichprobe von 149 Geflüchteten zeigte die Intervention eine klinische Wirksamkeit [17], breite Anwendbarkeit [18] und Kosten-Effektivität [19] im Vergleich zur Routineversorgung (Treatment-as-usual). beim Ein-und Durchschlafen sowie Konzentrationsprobleme und Kopfschmerzen, häufig in Zusammenhang mit Lärm in der Gemeinschaftsunterkunft.…”

Section: Interventionunclassified

Videogestützte Psychotherapie für Geflüchtete: Eine Pilotstudie

Schneider,

Wiechers,

Burger

et al. 2024

Psychother Psychosom Med Psychol

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Zusammenfassung Ziel der Studie Globale Konflikte und humanitäre Krisen führten in den vergangenen Jahren zu einer erhöhten Fluchtmigration nach Deutschland. Um perspektivisch die Versorgungsstruktur für Menschen mit Fluchthintergrund im deutschen Gesundheitssystem zu verbessern, werden im Rahmen dieser Pilotstudie erste Erfahrungen in der videogestützten Durchführung der Gruppenpsychotherapie Empowerment für Geflüchtete vorgestellt. Methodik Empowerment ist eine kultursensible, dolmetschergestützte Gruppentherapie zur Behandlung von depressiven und stressbezogenen Symptomen bei Geflüchteten. Vier afghanische Männer nahmen an der Pilotstudie teil. Die Intervention umfasste 16 Sitzungen, die innerhalb von 12 Wochen per Video durchgeführt wurden. Ergebnisse Die Internetverbindung war teils instabil und führte zu organisatorischen Herausforderungen. Sprachlich und interaktionell war die Therapie durchführbar. Diskussion Eine stabile Internetverbindung stellt das zentrale Kriterium für eine erfolgreiche Durchführung der Therapie dar. Es werden mögliche Lösungsansätze und Einschränkungen für zukünftige Studien diskutiert. Schlussfolgerung Hinsichtlich der potenziellen Chancen auf eine zukünftige Erweiterung der Versorgungsoptionen für Menschen mit Fluchthintergrund, könnte das videogestützte Therapiekonzept in einer randomisierten kontrollierten Studie untersucht werden.

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Mental Health and Social Support Interventions

Emmelkamp

2023

Mental Health of Refugees

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Predicting treatment outcomes of the Empowerment group intervention for refugees with affective disorders: Findings from the MEHIRA project

Cited by 5 publications

References 36 publications

Shared sorrow, shared costs: cost-effectiveness analysis of the Empowerment group therapy approach to treat affective disorders in refugee populations

Shared sorrow, shared costs: cost-effectiveness analysis of the Empowerment group therapy approach to treat affective disorders in refugee populations

Videogestützte Psychotherapie für Geflüchtete: Eine Pilotstudie

Mental Health and Social Support Interventions

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