Thumbnail Image
Item

Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance

Radhakrishnan, Muralikrishnan
; 
McCrone, Paul
; 
Lafortune, Louise
; 
Everard, Linda
; 
Fowler, David
; 
Amos, Tim
; 
Freemantle, Nick
; 
Singh, Swaran P.
; 
Marshall, Max
; 
Sharma, Vimal
... show 3 more
Citations
Altmetric:
Advisors
Editors
Other Contributors
Affiliation
King's College; University of Cambridge; Birmingham and Solihul Mental Health NHS Foundation Trust; University of Sussex; University of Bristol; University College London; University of Warwick; University of Manchester; Cheshire and Wirral NHS Foundation Trust and University of Chester; University of Birmingham
EPub Date
Publication Date
2017-08-31
Submitted Date
Collections
Health and Social Care
Show all metadata
Files
Thumbnail Image
Main article
Adobe PDF, 506.2 KB
Other Titles
Abstract
Introduction Early Intervention Services (EIS) for psychosis are being implemented, internationally. It is important to learn from established examples and define the components and intensity of services that provide good value for money. This study aims to assess the cost-effectiveness of EIS according to how closely they adhered to the recommendations of the English Department of Health 2001 Policy Implementation Guide (PIG). Methods EIS from the National Eden Study were assessed using a measure of fidelity to the PIG that rated the presence or absence of 64 recommended items relating to team structure and practice. EIS were then classified into three groups: those with fidelity of 75-80 %, 81%-90 %, and 91-95 %. Patient-level resource use and outcomes were measured one year following inception into the service; costs were calculated and combined with quality-adjusted life years (QALYs) gained. Results At a threshold of £20,000 per QALY, the 81-90% fidelity group had a 56.3% likelihood of being the most cost-effective option followed by 75-80% fidelity at 35.8% and 91-95% fidelity group (7.9%). Conclusions The results from England suggest that striving to maximise fidelity may not be warranted, but that dropping below a certain level of fidelity may result in inefficient use of resources.
Citation
Radhakrishnan, M., et al. (2017). Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance. Early Intervention in Psychiatry, 12(4).
Publisher
Wiley
Journal
Early Intervention in Psychiatry
Research Unit
URI
http://hdl.handle.net/10034/621180
DOI
10.1111/eip.12481
PubMed ID
PubMed Central ID
Type
Article
Language
en
Description
This is the peer reviewed version of the following article: Radhakrishnan, M., et al. (2017). Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance. Early Intervention in Psychiatry, 12(4), which has been published in final form at https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.12481. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
Series/Report no.
ISSN
EISSN
1751-7893
ISBN
ISMN
Gov't Doc
Test Link
Sponsors
Additional Links
https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.12481
Embedded videos