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Open AccessArticle

Cost–Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study)

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Group of Psychological Research in Fibromyalgia & Chronic Pain (AGORA), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
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Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
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Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
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Department of Clinical Psychology and Psychobiology (Section Personality, Assessment and Psychological Treatments), University of Barcelona, 08193 Barcelona, Spain
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The London School of Economics and Political Science (LSE), London WC2A 2AE, UK
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Department of Psychology, Uppsala University, SE-751 05 Uppsala, Sweden
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Primary Health Centre Bartomeu Fabrés Anglada, SAP Delta Llobregat, Unitat Docent Costa de Ponent, Institut Català de la Salut, 08850 Gavà, Spain
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Centre for Biomedical Research in Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain
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Fundació IDIAP Jordi Gol I Gurina, 08007 Barcelona, Spain
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Department of Psychiatry, Miguel Servet Hospital, Aragon Institute of Health Sciences (I+CS), 50009 Zaragoza, Spain
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(7), 1068; https://doi.org/10.3390/jcm8071068
Received: 19 June 2019 / Revised: 16 July 2019 / Accepted: 17 July 2019 / Published: 20 July 2019
(This article belongs to the Special Issue Rehabilitation for Persistent Pain Across the Lifespan)
Fibromyalgia (FM) is a prevalent, chronic, disabling, pain syndrome that implies high healthcare costs. Economic evaluations of potentially effective treatments for FM are needed. The aim of this study was to analyze the cost–utility of Mindfulness-Based Stress Reduction (MBSR) as an add-on to treatment-as-usual (TAU) for patients with FM compared to an adjuvant multicomponent intervention (“FibroQoL”) and to TAU. We performed an economic evaluation alongside a 12 month, randomized, controlled trial; data from 204 (68 per study arm) of the 225 patients (90.1%) were included in the cost–utility analyses, which were conducted both under the government and the public healthcare system perspectives. The main outcome measures were the EuroQol (EQ-5D-5L) for assessing Quality-Adjusted Life Years (QALYs) and improvements in health-related quality of life, and the Client Service Receipt Inventory (CSRI) for estimating direct and indirect costs. Incremental cost-effectiveness ratios (ICERs) were also calculated. Two sensitivity analyses (intention-to-treat, ITT, and per protocol, PPA) were conducted. The results indicated that MBSR achieved a significant reduction in costs compared to the other study arms (p < 0.05 in the completers sample), especially in terms of indirect costs and primary healthcare services. It also produced a significant incremental effect compared to TAU in the ITT sample (ΔQALYs = 0.053, p < 0.05, where QALYs represents quality-adjusted life years). Overall, our findings support the efficiency of MBSR over FibroQoL and TAU specifically within a Spanish public healthcare context. View Full-Text
Keywords: fibromyalgia; cost–utility; cost-effectiveness; quality-adjusted life years fibromyalgia; cost–utility; cost-effectiveness; quality-adjusted life years
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Pérez-Aranda, A.; D’Amico, F.; Feliu-Soler, A.; McCracken, L.M.; Peñarrubia-María, M.T.; Andrés-Rodríguez, L.; Angarita-Osorio, N.; Knapp, M.; García-Campayo, J.; Luciano, J.V. Cost–Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study). J. Clin. Med. 2019, 8, 1068.

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