Cost-Effectiveness of Digital Mental Health Versus Usual Care During Humanitarian Crises in Lebanon: Pragmatic Randomized Trial (Preprint)

• DOI: 10.2196/preprints.55544
• Publication Date: 2023-12-17T14:02:46Z
• Authors: Racha Abi Hana; Jinane Abi Ramia; Sebastian Burchert; Kenneth Carswell; Pim Cuijpers; Eva Heim; Christine Knaevel...; Philip Noun; Marit Sijbrandij; Mark van Ommeren; Edith van’t Hof; Ben Wijnen; Edwina Zoghbi; Rabih El Chammay; Filip Smit
• Keywords: Patient Health Questionnaire; Depression

<sec> <title>BACKGROUND</title> There is evidence from meta-analyses and systematic reviews that digital mental health interventions for depression, anxiety, stress-related disorders tend to be cost-effective. However, no such exists guided care in low middle-income countries (LMICs) facing humanitarian crises, where the needs are highest. Step-by-Step (SbS), a intervention disorders, proved effective Lebanese citizens war-affected Syrians residing Lebanon. Assessing cost-effectiveness of SbS crucial because Lebanon’s overstretched system must prioritize cost-effective treatment options face continuing economic crises. </sec> <title>OBJECTIVE</title> This study aims assess randomized comparison with enhanced usual (EUC). <title>METHODS</title> The analysis was conducted alongside pragmatic controlled trial 2 parallel groups comparing (n=614) EUC (n=635). primary outcome cost (in US $ reference year 2019) per response depressive symptoms, defined as &amp;gt;50% reduction symptoms measured using Patient Health Questionnaire (PHQ). secondary remission PHQ score &amp;lt;5 at last follow-up (5 months post baseline). evaluation first perspective then societal perspective. <title>RESULTS</title> Taking perspective, had an 80% probability regarded compared when there willingness pay $220 additional or $840 remission. wider &amp;gt;75% cost-saving while gaining <title>CONCLUSIONS</title> To our knowledge, this based on large (n=1249) LMIC. From principal findings, implications flowed, (1) (2) First, findings suggest associated greater benefits, albeit higher costs than EUC. It up decision makers decide if they find balance between gains acceptable. Second, seen substantial likelihood not costing more but cost-savings SBS participants become productive, thus offsetting their costs. finding may policy it interest both population economy implement wide scale. In brief, offer scalable, potentially emergencies <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT03720769; https://clinicaltrials.gov/ct2/show/NCT03720769 <title>INTERNATIONAL REGISTERED REPORT</title> RR2-10.2196/21585