Cost-Effectiveness & Efficacy of Computerized Therapy for Depression and Drug Use

成本效益

基本信息

批准号：
8910848
负责人：
Suzette V Glasner-Edwards
金额：
$ 30万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8910848
关键词：
Abstinence Address Adherence Adult Aftercare Alcohol or Other Drugs use Behavior Therapy Behavioral Cannabis Clinical Cognitive Therapy Communities Computer Assisted Computers Coping Skills Coupled Data Depressed mood Dimensions Disease Drug abuse Drug usage Effectiveness Ensure Evaluation Frequencies Future Health Healthcare Impulsivity Individual Intervention Intervention Studies Investigation K-Series Research Career Programs Knowledge Length Major Depressive Disorder Marijuana Dependence Marijuana Smoking Mediating Medication Management Mental Depression Mental Health Modality Modeling National Institute of Drug Abuse Neurobiology Outcome Participant Pharmaceutical Preparations Pharmacotherapy Phase Protocols documentation Psychiatric therapeutic procedure Psychotherapy Public Health Relapse Relative (related person)Research Research Design Sampling Self Efficacy Techniques Technology Testing Therapeutic Effect Therapeutic Studies Treatment Protocols Treatment Step Treatment outcome addiction alternative treatment base computerized cost cost effective cost effectiveness depressive symptoms discounting disorder later incidence prevention evidence base health care service utilization health related quality of life improved innovation intervention effect motivational enhancement therapy neurobehavioral prevent programs psychologic psychosocial reduced substance use skills social treatment adherence treatment as usual treatment duration treatment response treatment strategy

Abstinence Address Adherence Adult Aftercare Alcohol or Other Drugs use Behavior Therapy Behavioral Cannabis Clinical Cognitive Therapy Communities Computer Assisted Computers Coping Skills Coupled Data Depressed mood Dimensions Disease Drug abuse Drug usage Effectiveness Ensure Evaluation Frequencies Future Health Healthcare Impulsivity Individual Intervention Intervention Studies Investigation K-Series Research Career Programs Knowledge Length Major Depressive Disorder Marijuana Dependence Marijuana Smoking Mediating Medication Management Mental Depression Mental Health Modality Modeling National Institute of Drug Abuse Neurobiology Outcome Participant Pharmaceutical Preparations Pharmacotherapy Phase Protocols documentation Psychiatric therapeutic procedure Psychotherapy Public Health Relapse Relative (related person)Research Research Design Sampling Self Efficacy Techniques Technology Testing Therapeutic Effect Therapeutic Studies Treatment Protocols Treatment Step Treatment outcome addiction alternative treatment base computerized cost cost effective cost effectiveness depressive symptoms discounting disorder later incidence prevention evidence base health care service utilization health related quality of life improved innovation intervention effect motivational enhancement therapy neurobehavioral prevent programs psychologic psychosocial reduced substance use skills social treatment adherence treatment as usual treatment duration treatment response treatment strategy

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项目摘要

DESCRIPTION (provided by applicant): The objective of this research is to improve treatment for cannabis dependent adults with comorbid major depression by augmenting depression pharmacotherapy with an innovative, integrated computer-assisted strategy combining the techniques of cognitive behavioral therapy and motivational enhancement therapy (CBT/MET) to promote relapse prevention skills, reduce cannabis use and depressive symptoms, and improve psychiatric treatment adherence. In 2007 the applicant received a Career Development Award to study an integrated CBT/MET intervention for the treatment of substance users with comorbid major depression in a primary mental health care setting. Results show that (a) cannabis dependence is among the most frequently observed addictive disorders among depressed adults in this setting; (b) integrating CBT/MET with psychiatric treatment for depression produces significant reductions in depressive symptoms and facilitates reductions in cannabis use that are comparable to those observed in psychosocial intervention studies targeting cannabis dependence. To extend this model of evidence-based psychotherapy implementation for depressed cannabis users receiving usual care (TAU) in a primary psychiatric care setting to a computer-based platform, the specific aims of this research are: 1) To conduct an RCT among 195 depressed, cannabis dependent adults receiving TAU, comparing computer-assisted, integrated CBT/MET (cICBT/MET) addressing cannabis use and depression, relative to therapist-delivered integrated CBT/MET (tICBT/MET) and TAU alone in improving cannabis use, depression, psychiatric treatment adherence, and healthcare outcomes; 2) To determine the cost-effectiveness of cICBT/MET; and 3) To examine neurobehavioral predictors and mechanisms of action of cICBT/MET, including impulsivity, operationalized by delay discounting, and self-efficacy. We hypothesize that cICBT/MET will yield superior clinical outcomes relative to TAU in reducing substance use, improving depressive symptoms and psychiatric treatment adherence, and reducing health service utilization during and after treatment. Moreover, we expect that cICBT/MET will be less costly and at least as effective as cICBT/MET. Further, we expect that cICBT/MET will have a direct effect on psychological variables that are recognized mechanisms of change in CBT and MET, and these changes will be associated with cannabis use and depression outcomes. By providing support to maximize psychiatric treatment adherence, coupled with coping skills to prevent relapse, cICBT/MET may provide a promising, cost-effective, and easily deployable strategy for the treatment of depressed cannabis users.

描述（由申请人提供）：这项研究的目的是通过通过增强抑郁症药物治疗和一种创新的，集成的计算机辅助策略来改善依赖大麻依赖的成年人的治疗方法，结合了认知行为疗法和动机增强疗法（CBT/Met）的技术技术，以促进预防预测和抑郁症，并降低了症状，并降低了症状，并降低了治疗方法，并降低了症状，并降低了症状。在2007年，申请人获得了职业发展奖，以研究CBT/MET综合干预措施，以治疗在初级精神卫生保健环境中合并重大抑郁症的药物使用者。结果表明，在这种情况下，（a）大麻依赖性是抑郁症成年人中最常见的成瘾性疾病之一；（b）将CBT/与精神病治疗相结合以进行抑郁症可显着减少抑郁症状，并促进使用大麻使用的大麻使用的减少，与针对大麻依赖性的社会心理干预研究中观察到的大麻相媲美。为了将基于循证的心理治疗实施扩展到在原发性精神病护理环境中接受常规护理（TAU）的抑郁用户的实施模型，到基于计算机的平台，这项研究的具体目的是：1）在195个抑郁，依赖大麻依赖的成年人tau中进行RCT，以计算机依赖的CBT/METER（CICBT）（CICICBT）进行比较，以综合CBT/MET（TICBT/MET）和TAU仅在改善大麻使用，抑郁，精神病治疗依从性和医疗保健结果方面； 2）确定CICBT/MET的成本效益； 3）检查CICBT/MET的神经行为预测因子和作用机制，包括冲动性，通过延迟打折和自我效能进行操作。我们假设CICBT/MET将在减少药物使用，改善抑郁症状和精神病治疗依从性以及在治疗过程中和治疗期间降低卫生服务的利用率方面产生相对于TAU的较高临床结果。此外，我们预计CICBT/MET的成本较低，至少与CICBT/MET一样有效。此外，我们预计CICBT/MET将对CBT和MET变化的公认机制有直接影响，这些变化将与大麻使用和抑郁症结果有关。通过提供支持以最大程度地提高精神病治疗依从性，再加上应对技巧以防止复发，CICBT/MET可能会提供一种有希望的，具有成本效益且易于部署的策略，以治疗抑郁的大麻使用者。