Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta-review / Chris HOLLIS in Journal of Child Psychology and Psychiatry, 58-4 (April 2017)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 58-4 (April 2017) . - p.474-503 Titre : Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta-review Type de document : Texte imprimé et/ou numérique Auteurs : Chris HOLLIS, Auteur ; Caroline J. FALCONER, Auteur ; Jennifer L. MARTIN, Auteur ; Craig WHITTINGTON, Auteur ; Sarah STOCKTON, Auteur ; Cris GLAZEBROOK, Auteur ; E. Bethan DAVIES, Auteur Article en page(s) : p.474-503 Langues : Anglais (eng) Mots-clés : Digital health  mental health  eHealth  methodology  randomised controlled trials  prevention Index. décimale : PER Périodiques Résumé : Background Digital health interventions (DHIs), including computer-assisted therapy, smartphone apps and wearable technologies, are heralded as having enormous potential to improve uptake and accessibility, efficiency, clinical effectiveness and personalisation of mental health interventions. It is generally assumed that DHIs will be preferred by children and young people (CYP) given their ubiquitous digital activity. However, it remains uncertain whether: DHIs for CYP are clinically and cost-effective, CYP prefer DHIs to traditional services, DHIs widen access and how they should be evaluated and adopted by mental health services. This review evaluates the evidence-base for DHIs and considers the key research questions and approaches to evaluation and implementation. Methods We conducted a meta-review of scoping, narrative, systematic or meta-analytical reviews investigating the effectiveness of DHIs for mental health problems in CYP. We also updated a systematic review of randomised controlled trials (RCTs) of DHIs for CYP published in the last 3 years. Results Twenty-one reviews were included in the meta-review. The findings provide some support for the clinical benefit of DHIs, particularly computerised cognitive behavioural therapy (cCBT), for depression and anxiety in adolescents and young adults. The systematic review identified 30 new RCTs evaluating DHIs for attention deficit/hyperactivity disorder (ADHD), autism, anxiety, depression, psychosis, eating disorders and PTSD. The benefits of DHIs in managing ADHD, autism, psychosis and eating disorders are uncertain, and evidence is lacking regarding the cost-effectiveness of DHIs. Conclusions Key methodological limitations make it difficult to draw definitive conclusions from existing clinical trials of DHIs. Issues include variable uptake and engagement with DHIs, lack of an agreed typology/taxonomy for DHIs, small sample sizes, lack of blinded outcome assessment, combining different comparators, short-term follow-up and poor specification of the level of human support. Research and practice recommendations are presented that address the key research questions and methodological issues for the evaluation and clinical implementation of DHIs for CYP. En ligne : http://dx.doi.org/10.1111/jcpp.12663 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=305 [article] Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta-review [Texte imprimé et/ou numérique] / Chris HOLLIS, Auteur ; Caroline J. FALCONER, Auteur ; Jennifer L. MARTIN, Auteur ; Craig WHITTINGTON, Auteur ; Sarah STOCKTON, Auteur ; Cris GLAZEBROOK, Auteur ; E. Bethan DAVIES, Auteur . - p.474-503. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 58-4 (April 2017) . - p.474-503 Mots-clés : Digital health  mental health  eHealth  methodology  randomised controlled trials  prevention Index. décimale : PER Périodiques Résumé : Background Digital health interventions (DHIs), including computer-assisted therapy, smartphone apps and wearable technologies, are heralded as having enormous potential to improve uptake and accessibility, efficiency, clinical effectiveness and personalisation of mental health interventions. It is generally assumed that DHIs will be preferred by children and young people (CYP) given their ubiquitous digital activity. However, it remains uncertain whether: DHIs for CYP are clinically and cost-effective, CYP prefer DHIs to traditional services, DHIs widen access and how they should be evaluated and adopted by mental health services. This review evaluates the evidence-base for DHIs and considers the key research questions and approaches to evaluation and implementation. Methods We conducted a meta-review of scoping, narrative, systematic or meta-analytical reviews investigating the effectiveness of DHIs for mental health problems in CYP. We also updated a systematic review of randomised controlled trials (RCTs) of DHIs for CYP published in the last 3 years. Results Twenty-one reviews were included in the meta-review. The findings provide some support for the clinical benefit of DHIs, particularly computerised cognitive behavioural therapy (cCBT), for depression and anxiety in adolescents and young adults. The systematic review identified 30 new RCTs evaluating DHIs for attention deficit/hyperactivity disorder (ADHD), autism, anxiety, depression, psychosis, eating disorders and PTSD. The benefits of DHIs in managing ADHD, autism, psychosis and eating disorders are uncertain, and evidence is lacking regarding the cost-effectiveness of DHIs. Conclusions Key methodological limitations make it difficult to draw definitive conclusions from existing clinical trials of DHIs. Issues include variable uptake and engagement with DHIs, lack of an agreed typology/taxonomy for DHIs, small sample sizes, lack of blinded outcome assessment, combining different comparators, short-term follow-up and poor specification of the level of human support. Research and practice recommendations are presented that address the key research questions and methodological issues for the evaluation and clinical implementation of DHIs for CYP. En ligne : http://dx.doi.org/10.1111/jcpp.12663 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=305

Cost-effectiveness of psychological interventions for children and young people with post-traumatic stress disorder / Ifigeneia MAVRANEZOULI in Journal of Child Psychology and Psychiatry, 61-6 (June 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-6 (June 2020) . - p.699-710 Titre : Cost-effectiveness of psychological interventions for children and young people with post-traumatic stress disorder Type de document : Texte imprimé et/ou numérique Auteurs : Ifigeneia MAVRANEZOULI, Auteur ; Odette MEGNIN-VIGGARS, Auteur ; David TRICKEY, Auteur ; Richard MEISER-STEDMAN, Auteur ; Caitlin DALY, Auteur ; Sofia DIAS, Auteur ; Sarah STOCKTON, Auteur ; Stephen PILLING, Auteur Article en page(s) : p.699-710 Langues : Anglais (eng) Mots-clés : Post-traumatic stress disorder  decision-analytic modelling  economic evaluation  intervention Index. décimale : PER Périodiques Résumé : BACKGROUND: PTSD in youth may lead to long-lasting psychological implications, educational difficulties and increased healthcare costs. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of psychological interventions for children and young people with PTSD. METHODS: A decision-analytic model was constructed to compare costs and quality-adjusted life years (QALYs) of 10 psychological interventions and no treatment for children and young people with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion. RESULTS: Cognitive therapy for PTSD, a form of individual trauma-focused cognitive behavioural therapy (TF-CBT), appeared to be the most cost-effective intervention for children and young people with PTSD (with a probability of .78 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by narrative exposure (another form of individual TF-CBT), play therapy, and other forms of individual TF-CBT. After excluding cognitive therapy from the analysis, narrative exposure appeared to be the most cost-effective option with a .40 probability of being cost-effective amongst the remaining 10 options. EMDR, parent training and group TF-CBT occupied middle cost-effectiveness rankings. Family therapy and supportive counselling were less cost-effective than other active interventions. There was limited evidence for some interventions, in particular cognitive therapy for PTSD and parent training. CONCLUSIONS: Individual forms of TF-CBT and, to a lesser degree, play therapy appear to be cost-effective in the treatment of children and young people with PTSD. Family therapy and supportive counselling are unlikely to be cost-effective relative to other interventions. There is a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of psychological treatments for children and young people with PTSD. En ligne : http://dx.doi.org/10.1111/jcpp.13142 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426 [article] Cost-effectiveness of psychological interventions for children and young people with post-traumatic stress disorder [Texte imprimé et/ou numérique] / Ifigeneia MAVRANEZOULI, Auteur ; Odette MEGNIN-VIGGARS, Auteur ; David TRICKEY, Auteur ; Richard MEISER-STEDMAN, Auteur ; Caitlin DALY, Auteur ; Sofia DIAS, Auteur ; Sarah STOCKTON, Auteur ; Stephen PILLING, Auteur . - p.699-710. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-6 (June 2020) . - p.699-710 Mots-clés : Post-traumatic stress disorder  decision-analytic modelling  economic evaluation  intervention Index. décimale : PER Périodiques Résumé : BACKGROUND: PTSD in youth may lead to long-lasting psychological implications, educational difficulties and increased healthcare costs. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of psychological interventions for children and young people with PTSD. METHODS: A decision-analytic model was constructed to compare costs and quality-adjusted life years (QALYs) of 10 psychological interventions and no treatment for children and young people with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion. RESULTS: Cognitive therapy for PTSD, a form of individual trauma-focused cognitive behavioural therapy (TF-CBT), appeared to be the most cost-effective intervention for children and young people with PTSD (with a probability of .78 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by narrative exposure (another form of individual TF-CBT), play therapy, and other forms of individual TF-CBT. After excluding cognitive therapy from the analysis, narrative exposure appeared to be the most cost-effective option with a .40 probability of being cost-effective amongst the remaining 10 options. EMDR, parent training and group TF-CBT occupied middle cost-effectiveness rankings. Family therapy and supportive counselling were less cost-effective than other active interventions. There was limited evidence for some interventions, in particular cognitive therapy for PTSD and parent training. CONCLUSIONS: Individual forms of TF-CBT and, to a lesser degree, play therapy appear to be cost-effective in the treatment of children and young people with PTSD. Family therapy and supportive counselling are unlikely to be cost-effective relative to other interventions. There is a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of psychological treatments for children and young people with PTSD. En ligne : http://dx.doi.org/10.1111/jcpp.13142 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426

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