The British Journal of Psychiatry (2007) 191: 436-440. doi: 10.1192/bjp.bp.107.036806
© 2007 The Royal College of Psychiatrists
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Economic evaluation of a randomised controlled trial for anorexia nervosa in adolescents{dagger}

SARAH BYFORD, MSc and BARBARA BARRETT, MSc

King’s College London, Centre for the Economics of Mental Health, Institute of Psychiatry, London

CHRIS ROBERTS, PhD

Biostatistics Group, Division of Epidemiology and Health Sciences, University of Manchester

ANDREW CLARK, FRCPsych

Bolton Salford and Trafford Mental Health NHS Trust, Manchester

VANESSA EDWARDS, BA

Peninsular College of Medicine and Dentistry, Exeter

NICOLA SMETHURST, BA and SIMON G. GOWERS, FRCPsych

University of Liverpool, Section of Adolescent Psychiatry, Academic Unit, Chester, UK

Correspondence: Sarah Byford, Box No 24, Centre for the Economics of Mental Health, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: s.byford{at}iop.kcl.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

{dagger} See pp. 427–435, this issue.

Background Young people with anorexia nervosa are often admitted to hospital for treatment. As well as being disruptive to school, family and social life, in-patient treatment is expensive, yet cost-effectiveness evidence is lacking.

Aims Cost-effectiveness analysis of three treatment strategies for adolescents with anorexia nervosa.

Method UK multicentre randomised, controlled trial comparing in-patient psychiatric treatment, specialist out-patient treatment and general out-patient treatment. Outcomes and costs assessed at baseline, 1 and 2 years.

Results There were 167 young people in the trial. There were no statistically significant differences in clinical outcome between the three groups at 2 years. The specialist out-patient group was less costly over the 2-year follow-up (mean total cost £26 738) than the in-patient (£34 531) and general out-patient treatment (£40 794) groups, but this result was not statistically significant. Exploration of the uncertainty associated with the costs and effects of the three treatments suggests that specialist out-patient treatment has the highest probability of being cost-effective.

Conclusions On the basis of cost-effectiveness, these results supportthe provision of specialist out-patient services for adolescents with anorexia nervosa.


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SIMON G. GOWERS, ANDREW CLARK, CHRIS ROBERTS, ALISON GRIFFITHS, VANESSA EDWARDS, CLAUDINE BRYAN, NICOLA SMETHURST, SARAH BYFORD, and BARBARA BARRETT
BJP 2007 191: 427-435. [Abstract] [Full Text]  

PETER TYRER
BJP 2007 191: 470. [Full Text]  



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