Societal participation with Boston Psychiatric Rehabilitation for patients with severe mental illness: a cost effectiveness study - Promotieonderzoek
Drs. S.A. Sanches, Prof. dr. J. van Weeghel, Dr. W. Swildens, Dr. J. van Buuschbach
Besides symptom management, patients with Severe Mental Illness (SMI) need support in societal participation. The Boston University approach to Psychiatric Rehabilitation (BPR) is developed to support SMI patients in the life domains living, working, study and having social contacts. RCT’s into BPR were performed with largely positive outcomes in terms of participation but information about the cost effectiveness of BPR is lacking.
The primary research question is if BPR (cost) is effective compared to Care as Usual (CAU) after 12 months for patients with SMI who have a wish for change in societal participation, defined as a paid or voluntary job, studying, or caring full-time for a family.
The research is conducted as a multicentre RCT comparing cost effectiveness of care as usual (CAU) and BPR with measurements at baseline, 6 and 12 months. The study population is SMI patients; age 18-60 years, with a wish for change in societal participation recruited at two MHC organizations and a center for supported living.
Primary outcome is (positive) changes in societal participation. Secondary outcomes are hours of societal participation, position on the societal participation ladder; patients view on goal attainment;quality of life; symptoms, functioning; self-esteem.
The study also involves an economic evaluation from a societal perspective with a cost effectiveness study including all direct and indirect, medical and non-medical costs and a cost-utility analysis with QALYs as primary outcome. A budget impact analysis (BIA) will be conducted to inform decision-makers about the financial consequences of further diffusion of BPR in the healthcare system.