title: Cost-utility of a psychoeducational intervention in fibromyalgia patients compared with usual care: an economic evaluation alongside a 12-month randomized controlled trial.
abstract: OBJECTIVE
  To determine the effectiveness of adding psychoeducational treatment implemented in general practice to usual care for patients with fibromyalgia (FM), and to analyze the cost-utility of the intervention from health care and societal perspectives.
  
  
  METHODS
  Twelve-month randomized controlled trial. A total of 216 primary care patients meeting the American College of Rheumatology criteria for FM participated in the study. The intervention included 9, 2-hour sessions of psychoeducation (5 sessions of education about the illness+4 sessions of autogenic relaxation) added to usual care provided by a multidisciplinary group in general practice was compared to usual care in the public health system.
  
  
  RESULTS
  At 12-month follow-up, patients who received psychoeducation showed greater improvement in global functional status (Cohen d=0.36; -2.49 to 3.81), physical functioning (Cohen d=0.56; 0.08 to 1.00), days feeling well (Cohen d=0.40; -0.16 to 1.02), pain (Cohen d= 0.35; -0.04 to 0.80), morning fatigue (Cohen d=0.24; -0.20 to 0.76), stiffness (Cohen d=0.34; -0.10 to 0.87), and depression (Cohen d=0.30; -0.26 to 0.93). Mean incremental cost per person receiving the intervention was &OV0556;-215.49 (-615.13 to 287.81) from the health care perspective, and &OV0556;-197.32 (-785.12 to 395.74) from the societal perspective. The incremental gain in quality-adjusted life-years per person was 0.12 (0.06 to 0.19), yielding a "dominant" intervention from both perspectives. The sensitivity analysis suggested that the intervention was cost-effective even imputing all missing data.
  
  
  CONCLUSIONS
  Our findings demonstrate the long-term clinical effectiveness of a psychoeducational treatment program for FM implemented at primary care level and the cost-utility from a health care and societal perspective.
  
  
  BACKGROUND
  NCT00550966.
authors: Research and Development Unit, Parc Sanitari Sant Joan de Déu., Sant Boi del Llobregat, Barcelona, Spain.
authors: Juan V
authors: JV
authors: Luciano
authors: Ramon
authors: R
authors: Sabes-Figuera
authors: Eugenia
authors: E
authors: Cardeñosa
authors: María
authors: M
authors: T Peñarrubia-María
authors: Rita
authors: R
authors: Fernández-Vergel
authors: Javier
authors: J
authors: García-Campayo
authors: Martin
authors: M
authors: Knapp
authors: Antoni
authors: A
authors: Serrano-Blanco
mesh_terms: D000368:Aged; D057189:Checklist; D003362:Cost-Benefit Analysis; D005260:Female; D005356:Fibromyalgia / Q000523:psychology* / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011613:Psychotherapy / Q000193:education* / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D013030:Spain; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome