Vj. Thomas et al., Cognitive-behavioural therapy for the management of sickle cell disease pain: Identification and assessment of costs, ETHN HEALTH, 6(1), 2001, pp. 59-67
Objective. The aim of the present study was to investigate the economic val
idity of using a psychological intervention in the management of sickle cel
l disease (SCD). Thomas et al. (Br J Health Psychol 1999; 4: 209-29) conclu
ded that cognitive-behaviour therapy (CBT) appears to be immediately effect
ive for the management of SCD pain in terms of reducing psychological distr
ess pain as well as improving coping.
Method. The costs of management of SCD were evaluated using a societal view
point. This approach includes health and social services as well as costs p
rivately borne by informal carers, but it did not include the economic loss
due to patients' foregone earnings. Cost profiles were constructed for eac
h patient taking account of cost generating events 12 months before and 12
months after CBT.
Results. The hypothesis of the present study, stating that CBT is economica
lly efficient, was confirmed. However, analysis of longitudinal data sugges
ts that CBT is most cost-effective during the first 6 months after the inte
rvention.
Conclusion. The present findings suggest the need for CBT to be integrated
into the normal package of care available for all patients with SCD. The cl
inical implication is that CBT should be routinely offered to patients on a
6-monthly basis.