Patient-reported outcome measures (PROMs) are commonly collected in trials and some care settings, but preference-based PROMs required for economic evaluation based on quality-adjusted life years (QALYs) are often missing.
We used trial data from people recruited within NHS Talking Therapies (previously called Improving Access to Psychological Therapies) services, England, to develop a series of mapping models to predict preference-based scores from two mental health PROMs: Patient Health Questionnaire-9 (PHQ-9; depression) and Generalised Anxiety Questionnaire-7 (GAD-7; anxiety). Our mapping functions can predict EQ-5D five-level (EQ-5D-5L) or Recovering Quality of Life Utility Index (ReQoL-UI) related utility scores for QALY estimation as a function of variables routinely collected within mental health services or trials, such as the PHQ-9 and/or GAD-7 summary scores, age, and sex. Thus, it is now possible to conduct economic evaluations such as cost per QALY analyses using routinely collected Talking Therapies data. Publication available here.
Our next study will:
- We used these mapping functions to enable us to conduct an economic evaluation of an Enhanced Talking Therapies service versus Talking Therapies service-as-usual, funded by the NIHR SPHR with analyses supported by the ARC-YH: the ADAPT study. A preprint is available for the economic evaluation, with the statistical analyses already published.
- We are planning on conducting further economic evaluations enabled by the mapping functions, to compare different talking therapies head-to-head, such as cognitive behaviour therapy (CBT) compared to counselling in people with depression, using routinely collected Talking Therapies data
- Further mapping functions are needed in mental health populations, such as within people with more severe anxiety and depression, and other mental health conditions like post-traumatic stress disorder (PTSD) based on different condition-specific measures like the PTSD Checklist for DSM-5 (PCL-5).
