COST-EFFECTIVENESS OF COGNITIVE BEHAVIOURAL THERAPY VERSUS HEALTH EDUCATION FOR SLEEP DISTURBANCE AND FATIGUE FOLLOWING STROKE AND TRAUMATIC BRAIN INJURY.

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Title:	COST-EFFECTIVENESS OF COGNITIVE BEHAVIOURAL THERAPY VERSUS HEALTH EDUCATION FOR SLEEP DISTURBANCE AND FATIGUE FOLLOWING STROKE AND TRAUMATIC BRAIN INJURY.
Authors:	MORTIMER, Duncan, YMER, Lucy, MCKAY, Adam, WONG, Dana, FRENCHAM, Kate, GRIMA, Natalie, ROPER, Monique, NGUYEN, Sylvia, MURRAY, Jade, SPITZ, Gershon, PONSFORD, Jennie
Source:	Journal of Rehabilitation Medicine. 2025, Issue 57, p1-9. 9p.
Subjects:	Cognitive therapy, Brain injuries, Sleep disorders, Health education, Medical care costs
Abstract:	Objective: Evaluate cost, effectiveness and costeffectiveness of cognitive behavioural therapy for sleep and fatigue (CBT-SF) vs health education (HE) and of CBT-SF vs treatment as usual (TAU) for sleep disturbance and fatigue in acquired brain injury. Design: Economic evaluation from Australian health system and societal perspectives based on data from a June 2017 to October 2023 randomized controlled trial. Subjects: Community-dwelling Australian adults with sleep disturbance and fatigue following acquired brain injury (n = 126). Methods: Incremental health system costs based on cost of delivery and health service utilization since last follow-up. Incremental effectiveness based on participant-reported sleep quality, fatigue, and quality of life at each timepoint. Productivity gains/losses based on a 1-week activity diary at each timepoint. Results: Reductions in health service utilization from CBT-SF (-A$777, 95% CI: -A$4,232, A$2,678) offset higher delivery costs (A$333, 95% CI: A$109, A$556) relative to HE, with improvements in quality of life at 2 months post-treatment (0.02, 95% CI: -0.01, 0.05) and an additional 3.37 qualityadjusted life days per participant (95% CI: -4.18, 10.92). CBT-SF dominates HE (less costly and more effective) and is likely more cost-effective than HE (66-76%). CBT-SF is cost-effective relative to TAU under realistic assumptions. Conclusions: CBT-SF after acquired brain injury improved clinical and economic outcomes and was more likely to be cost-effective than HE. Further research is required to precisely estimate the costeffectiveness of CBT-SF vs TAU and to demonstrate generalizability to routine practice and other settings. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Objective: Evaluate cost, effectiveness and costeffectiveness of cognitive behavioural therapy for sleep and fatigue (CBT-SF) vs health education (HE) and of CBT-SF vs treatment as usual (TAU) for sleep disturbance and fatigue in acquired brain injury. Design: Economic evaluation from Australian health system and societal perspectives based on data from a June 2017 to October 2023 randomized controlled trial. Subjects: Community-dwelling Australian adults with sleep disturbance and fatigue following acquired brain injury (n = 126). Methods: Incremental health system costs based on cost of delivery and health service utilization since last follow-up. Incremental effectiveness based on participant-reported sleep quality, fatigue, and quality of life at each timepoint. Productivity gains/losses based on a 1-week activity diary at each timepoint. Results: Reductions in health service utilization from CBT-SF (-A$777, 95% CI: -A$4,232, A$2,678) offset higher delivery costs (A$333, 95% CI: A$109, A$556) relative to HE, with improvements in quality of life at 2 months post-treatment (0.02, 95% CI: -0.01, 0.05) and an additional 3.37 qualityadjusted life days per participant (95% CI: -4.18, 10.92). CBT-SF dominates HE (less costly and more effective) and is likely more cost-effective than HE (66-76%). CBT-SF is cost-effective relative to TAU under realistic assumptions. Conclusions: CBT-SF after acquired brain injury improved clinical and economic outcomes and was more likely to be cost-effective than HE. Further research is required to precisely estimate the costeffectiveness of CBT-SF vs TAU and to demonstrate generalizability to routine practice and other settings. [ABSTRACT FROM AUTHOR]
ISSN:	16501977
DOI:	10.2340/jrm.v57.42770