Cost‐utility of an internet‐based intervention with or without therapist support in comparison with a waiting list for individuals with eating disorder symptoms: a randomized controlled trial
Open accessAbstract
Objective: To investigate the cost‐utility of the internet‐based intervention “Featback” provided with different levels of therapist support, in comparison to a waiting list. Method: This economic evaluation was conducted from a societal perspective and was part of a randomized controlled trial in which participants (N = 354) with self‐reported ED symptoms were randomized to: (1) 8 weeks of Featback, consisting of psychoeducation and a fully automated monitoring‐ and feedback system, (2) Featback with low‐intensity (weekly) therapist support, (3) Featback with high‐intensity (three times a week) therapist support, and (4) a waiting list. Participants were assessed at baseline, postintervention, and 3‐month follow‐up. Cost‐utility acceptability curves were constructed. Results: No significant differences between the study conditions were found regarding quality‐adjusted life‐years (P = 0.55) and societal costs (P = 0.45), although the mean costs per participant were lowest in the Featback condition with low‐intensity therapist support (€1951), followed by Featback with high‐intensity therapist support (€2032), Featback without therapist support (€2102), and the waiting list (€2582). Featback seemed to be cost‐effective as compared to the waiting list. No clear preference was found for Featback with or without therapist support. Discussion: A fully automated Internet‐based intervention for ED symptoms with no, low‐, or high‐intensity therapist support represented good value for money when compared to a waiting list. This finding may have important implications for clinical practice, as both the unguided‐ and guided intervention could allow for more efficient care and widespread dissemination, potentially increasing the accessibility and availability of mental health care services for individuals with ED symptoms. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1068–1076)
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Internet-based interventions have the potential to overcome some barriers to help-seeking by offering anonymity, privacy, accessibility, availability, and cost-effectiveness, and may be perceived as less stigmatising than face-to-face treatments.
“Internet-based interventions have the potential to overcome some of these barriers by offering anonymity, privacy, accessibility, availability, and cost-effectiveness, and may be perceived as less stigmatising than face-to-face treatments [15–18].”
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- Authors
- Aardoom, J. J., Dingemans, A. E., van Ginkel, J. R., Spinhoven, P., Van Furth, E. F., & Van den Akker‐van Marle, M. E.
- Affiliations
- GGZ Rivierduinen (NL)
- Institute of Education and Child Studies, Leiden University Leiden The Netherlands
- Leiden University (NL)
- Rivierduinen Eating Disorders Ursula Leiden The Netherlands
- Department of Medical Decision Making Leiden University Medical Center Leiden The Netherlands
- Corresponding author
- Aardoom, J.J.
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2016-07-21
- Volume
- 49
- Issue
- 12
- Pages
- 1068-1076
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- OpenAlex
- W2498826386
- Cited by
- 30
- References
- 41
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 4
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- European Commission's Executive Agency for Health and Consumers in the Health Program (20101209)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- eating disorder symptoms, online intervention, therapist support, cost-utility analysis, cost-effectiveness, automated feedback systems, psychoeducation, waiting lists, quality-adjusted life years, access to mental health care
- MeSH terms
- Adult, Feeding and Eating Disorders, Cost-Benefit Analysis, Female, Health Personnel, Humans, Male, Patient Education as Topic, Quality of Life, Social Support, Waiting Lists, Cognitive Behavioral Therapy, Quality-Adjusted Life Years, Internet, Young Adult, Self Report
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