title: Psycho-educational CBT-Insomnia workshops in the community. A cost-effectiveness analysis alongside a randomised controlled trial.
abstract: Around one in three of the UK population suffer from sleep problems, resulting in high costs to society. Cognitive behaviour therapy for insomnia (CBT-I) has been shown to be effective. Community-based workshops may be a cost-effective way to provide CBT-I to groups that are usually hard to reach or reluctant to seek treatment. A sample of 151 participants aged 18 or over from five London boroughs who self-referred were randomised into a group receiving workshops and a waiting list control group. 111 provided complete data on service use and outcome measures. Results from the cost-effectiveness and cost-utility analyses are presented using cost-effectiveness acceptability curves. At a maximum willingness to pay per quality-adjusted life-year (QALY) of £30,000, the probability of the intervention being cost-effective is 80%. If commissioners are willing to pay £150 per point improvement on the Insomnia Severity Index, which is approximately the cost of the intervention, there is a 97% probability of cost-effectiveness. Community-based CBT-I workshops are likely to be a cost-effective intervention to improve insomnia symptoms and are a promising low-level option to include within the panoply of interventions that are encouraged within the UK policy of increasing access to psychological therapies.
authors.affiliation: Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK. Electronic address: e.bonin@lse.ac.uk.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Bonin
authors.affiliation: Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK; Personal Social Services Research Unit, University of Kent, Canterbury CT2 7NF, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beecham
authors.affiliation: Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Naomi
authors.initials: N
authors.lastname: Swift
authors.affiliation: Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Shriti
authors.initials: S
authors.lastname: Raikundalia
authors.affiliation: Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK.
authors.forename: June S L
authors.initials: JS
authors.lastname: Brown
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D004493:Education / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D018803:Models, Economic; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000191:economics*; D012111:Residence Characteristics; D007319:Sleep Initiation and Maintenance Disorders / Q000191:economics / Q000628:therapy*; D055815:Young Adult
keywords: Cognitive behaviour therapy; Cost effectiveness; Costs and cost analysis; Group intervention; Insomnia; Self referral