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Wagner, Adam P. 
ORCID: https://orcid.org/0000-0002-9101-3477, Galante, Julieta, Dufour, Géraldine, Barton, Garry, Stochl, Jan, Vainre, Maris and Jones, Peter B.
(2023)
Cost-effectiveness of providing university students with a mindfulness-based intervention to reduce psychological distress: Economic evaluation of a pragmatic randomised controlled trial.
BMJ Open, 13.
ISSN 2044-6055
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Abstract
Objective Increasing numbers of young people attending university has raised concerns about the capacity of student mental health services to support them. We conducted a randomised controlled trial (RCT) to explore whether provision of an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students - MSS), compared with university mental health support as usual (SAU), reduced psychological distress during the examination period. Here, we conduct an economic evaluation of MSS+SAU compared with SAU. Design and setting Economic evaluation conducted alongside a pragmatic, parallel, single-blinded RCT comparing provision of MSS+SAU to SAU. Participants 616 university students randomised. Primary and secondary outcome measures The primary economic evaluation assessed the cost per quality-adjusted life year (QALY) gained from the perspective of the university counselling service. Costs relate to staff time required to deliver counselling service offerings. QALYs were derived from the Clinical Outcomes in Routine Evaluation Dimension 6 Dimension (CORE-6D) preference based tool, which uses responses to six items of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM; primary clinical outcome measure). Primary follow-up duration was 5 and 7 months for the two recruitment cohorts. Results It was estimated to cost £1584 (2022 prices) to deliver an MSS course to 30 students, £52.82 per student. Both costs (adjusted mean difference: £48, 95% CI £40-£56) and QALYs (adjusted mean difference: 0.014, 95% CI 0.008 to 0.021) were significantly higher in the MSS arm compared with SAU. The incremental cost-effectiveness ratio (ICER) was £3355, with a very high (99.99%) probability of being cost-effective at a willingness-to-pay threshold of £20 000 per QALY. Conclusions MSS leads to significantly improved outcomes at a moderate additional cost. The ICER of £3355 per QALY suggests that MSS is cost-effective when compared with the UK's National Institute for Health and Care Excellence thresholds of £20 000 per QALY. Trial registration number Australian and New Zealand Clinical Trials Registry, ACTRN12615001160527.
| Item Type: | Article |
|---|---|
| Additional Information: | Data availability statement: Data are available upon reasonable request. Deidentified individual participant data and dictionary are available for researchers upon request from the corresponding author after approval of a proposal, with a signed data access agreement. Funding Information: This is a summary of research funded by the University of Cambridge Vice-Chancellor’s Endowment Fund, the University Counselling Service and the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East of England (ARC EoE) programme. The views expressed are those of the authors and not necessarily those of the University of Cambridge, NHS, NIHR or Department of Health and Social Care. |
| Uncontrolled Keywords: | health economics,mental health,psychiatry,medicine(all),sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Medicine and Health Sciences > School of Health Sciences |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging |
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| Depositing User: | LivePure Connector |
| Date Deposited: | 01 Nov 2024 12:31 |
| Last Modified: | 04 Nov 2024 12:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/97426 |
| DOI: | 10.1136/bmjopen-2023-071724 |
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