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Clinical effectiveness and cost minimisation model of Alpha-Stim cranial electrotherapy stimulation in treatment seeking patients with moderate to severe generalised anxiety disorder

Morriss, Richard; Xydopoulos, Georgios; Craven, Michael; Price, Larry; Fordham, Richard

Clinical effectiveness and cost minimisation model of Alpha-Stim cranial electrotherapy stimulation in treatment seeking patients with moderate to severe generalised anxiety disorder Thumbnail


Authors

RICHARD MORRISS richard.morriss@nottingham.ac.uk
Professor of Psychiatry and Community Mental Health

Georgios Xydopoulos

Larry Price

Richard Fordham



Abstract

© 2019 Elsevier B.V. Background: Cranial electrotherapy stimulation (CES) is a well-tolerated neuromodulation treatment with demonstrated trial efficacy in anxiety disorders. The aim of the current study was to demonstrate its clinical and cost effectiveness during and after CES in people with generalised anxiety disorder (GAD) who had not responded to low intensity psychological treatment in a routine health service. Methods: Consecutive sample of eligible patients with GAD waiting for individual cognitive behaviour therapy (CBT) selected from two publicly funded services in England. They received 60 min per day Alpha-Stim CES for 6–12 weeks. Primary outcome was remission on the GAD-7 scale at 12 and 24 weeks. Cost effectiveness was examined using a cost minimisation model of direct health costs. Results: Of 161 patients recruited, 72 (44.7%) and 77 (47.8%) achieved remission on the GAD-7 at 12 and 24 weeks respectively with 122 (75.8%) receiving at least 6 weeks CES. Mean (sd) GAD-7 score at baseline significantly improved from 15.77 (3.21) to 8.92 (5.42) and 8.99 (6.18) at 12 and 24 weeks respectively (p < 0.001). 80 (49.7%) participants required further individual CBT. CES provided a saving of £540.88 per patient (95% CI −£327.12, £648.69). Limitations: Participants were not randomised and there was no control group. Only 48 (29.9%) participants completed every assessment. Conclusion: In patients with generalised anxiety disorder not responding to low intensity psychological treatment, 6–12 weeks daily Alpha Stim CES may be effective after treatment and 3 months later, thereby reducing the need for individual CBT and saving health costs.

Journal Article Type Article
Acceptance Date Apr 7, 2019
Online Publication Date Apr 15, 2019
Publication Date Jun 15, 2019
Deposit Date Apr 9, 2019
Publicly Available Date Apr 16, 2020
Journal Journal of Affective Disorders
Electronic ISSN 1573-2517
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 253
Pages 426-437
DOI https://doi.org/10.1016/j.jad.2019.04.020
Keywords Clinical electrotherapy, Neuromodulation, Generalised anxiety disorder, Cost effectiveness
Public URL https://nottingham-repository.worktribe.com/output/1768988
Publisher URL https://www.sciencedirect.com/science/article/pii/S0165032718325023
Additional Information Faculty of Engineering Bioengineering Research Group
Institute of Mental Health
Nottingham Biomedical Research Centre

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