, Volume 45, Issue 7, pp 741-750
Date: 18 Aug 2009

Cost-effectiveness analysis of an occupational therapy-led lifestyle approach and routine general practitioner’s care for panic disorder

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To assess the cost-effectiveness of an occupational therapy-led lifestyle approach to treating panic disorder in primary care compared with routine general practitioner’s (GP) care. The burden of mental health disorders is considerable. Cost-effective interventions are necessary to alleviate some of these burdens. Habitual lifestyle behaviours influence mood, although to date mainly single lifestyle factor trials have been conducted to examine the effects on anxiety.


An economic evaluation was conducted alongside an unblinded pragmatic randomised controlled trial with assessment at 5 and 10 months. Costs and consequences, as measured by the Beck anxiety inventory (BAI) and quality adjusted life years (QALYs), were compared using incremental cost-effectiveness ratios (ICERs).


The occupational therapy-led lifestyle intervention was more costly than routine GP care at both 5 and 10 months. Significant outcome improvements were evident at 5 months when using the BAI, although these were not maintained at 10 months. Small differences in mean QALYs were found. The estimated ICER was £36 per BAI improvement for 5 months and £39 for 10 months, and £18,905 per QALY gained for 5 months and £8,283 for 10 months.


If the maximum willingness to pay per additional QALY is £30,000, then there is an 86% chance that a lifestyle intervention may be considered to be value-for-money over 10 months.

The main results from this research were presented at the 33rd North American Primary Care Research Group Meeting held in Quebec City on 15–18 October 2005.