@Article{信息:doi 10.2196 / / jmir。9997，作者=“Ferwerda, Maaike和van Beugen, Sylvia和van Middendorp, Henri{\"e}t和Visser, Henk和Vonkeman, Harald和Creemers, Marjonne和van Riel, Piet和Kievit, Wietske和Evers, Andrea”，标题=“定制的，治疗师指导的基于互联网的认知行为治疗与常规护理的类风湿关节炎患者的比较:，期刊=“J Med Internet Res”，年=“2018”，月=“10”，日=“11”，量=“20”，数=“10”，页数=“e260”，关键词=“成本-效用分析;认知行为治疗;以互联网为基础的疗法;背景:基于互联网的认知行为疗法可以帮助痛苦水平升高的类风湿关节炎患者提高生活质量。然而，目前缺乏实施，几乎没有证据表明不同治疗策略的(成本)有效性。目的:成本效益比对于告知利益相关者并激励他们实施有效的治疗策略以改善类风湿性关节炎患者的健康相关生活质量(HRQoL)是必要的。一项从社会角度进行的成本效益研究与一项随机对照试验一起进行，该试验针对痛苦水平升高的类风湿性关节炎患者进行定制的、治疗师指导的基于互联网的认知行为疗法(ICBT)干预，作为常规护理(CAU)的补充。方法:在基线或干预前，干预6个月或干预后，以及此后1年随访中每3个月收集一次数据。 Effects were measured in terms of quality-adjusted life years (QALYs) and costs from a societal perspective, including health care sector costs (health care use, medication, and intervention costs), patient travel costs for health care use, and costs associated with loss of labor. Results: The intervention improved the quality of life compared with only CAU ($\Delta$ QALYs=0.059), but at a higher cost ($\Delta$={\texteuro}4211). However, this increased cost substantially reduced when medication costs were left out of the equation ($\Delta$={\texteuro}1863). Of all, 93{\%} (930/1000) of the simulated incremental cost-effectiveness ratios were in the north-east quadrant, indicating a high probability that the intervention was effective in improving HRQoL, but at a greater monetary cost for society compared with only CAU. Conclusions: A tailored and guided ICBT intervention as an addition to CAU for patients with rheumatoid arthritis with elevated levels of distress was effective in improving quality of life. Consequently, implementation of ICBT into standard health care for patients with rheumatoid arthritis is recommended. However, further studies on cost reductions in this population are warranted. Trial Registration: Nederlands Trial Register NTR2100; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2100 (Archived by WebCite at http://www.webcitation.org/724t9pvr2) ", issn="1438-8871", doi="10.2196/jmir.9997", url="//www.mybigtv.com/2018/10/e260/", url="https://doi.org/10.2196/jmir.9997", url="http://www.ncbi.nlm.nih.gov/pubmed/30309835" }