eprintid: 10161726 rev_number: 18 eprint_status: archive userid: 699 dir: disk0/10/16/17/26 datestamp: 2022-12-14 11:29:17 lastmod: 2024-11-07 15:20:29 status_changed: 2023-05-02 17:26:49 type: article metadata_visibility: show sword_depositor: 699 creators_name: Hollis, Chris creators_name: Hall, Charlotte L creators_name: Khan, Kareem creators_name: Jones, Rebecca creators_name: Marston, Louise creators_name: Le Novere, Marie creators_name: Hunter, Rachael creators_name: Andren, Per creators_name: Bennett, Sophie creators_name: Brown, Beverley J creators_name: Chamberlain, Liam creators_name: Davies, E Bethan creators_name: Evans, Amber creators_name: Kouzoupi, Natalia creators_name: McKenzie, Caitlin creators_name: Sanderson, Charlotte creators_name: Heyman, Isobel creators_name: Kilgariff, Joseph creators_name: Glazebrook, Cristine creators_name: Mataix-Cols, David creators_name: Serlachius, Eva creators_name: Murray, Elizabeth creators_name: Murphy, Tara title: Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial ispublished: inpress subjects: GOSH divisions: UCL divisions: B02 divisions: D13 divisions: G25 keywords: Tic disorders; randomised controlled trial; long-term follow-up; exposure and response prevention; digital intervention. note: © 2023 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. abstract: Background Little is known about the long-term effectiveness of behavioural therapy for tics. We aimed to assess the long-term clinical and cost-effectiveness of online therapist-supported exposure and response prevention (ERP) therapy for tics 12 and 18 months after treatment initiation. Methods ORBIT (online remote behavioural intervention for tics) was a two-arm (1:1 ratio), superiority, single-blind, multicentre randomised controlled trial comparing online ERP for tics with online psychoeducation. The trial was conducted across two Child and Adolescent Mental Health Services in England. Participants were recruited from these two sites, across other clinics in England, or by self-referral. This study was a naturalistic follow-up of participants at 12- and 18-month postrandomisation. Participants were permitted to use alternative treatments recommended by their clinician. The key outcome was the Yale Global Tic Severity Scale Total Tic Severity Score (YGTSS-TTSS). A full economic evaluation was conducted. Registrations are ISRCTN (ISRCTN70758207); ClinicalTrials.gov (NCT03483493). Results Two hundred and twenty-four participants were enrolled: 112 to ERP and 112 to psychoeducation. The sample was predominately male (177; 79%) and of white ethnicity (195; 87%). The ERP intervention reduced baseline YGTSS-TTSS by 2.64 points (95% CI: −4.48 to −0.79) with an effect size of −0.36 (95% CI: −0.61 to −0.11) after 12 months and by 2.01 points (95% CI: −3.86 to −0.15) with an effect size of −0.27 (95% CI -0.52 to −0.02) after 18 months, compared with psychoeducation. Very few participants (<10%) started new tic treatment during follow-up. The cost difference in ERP compared with psychoeducation was £304.94 (−139.41 to 749.29). At 18 months, the cost per QALY gained was £16,708 for ERP compared with psychoeducation. Conclusions Remotely delivered online ERP is a clinical and cost-effective intervention with durable benefits extending for up to 18 months. This represents an efficient public mental health approach to increase access to behavioural therapy and improve outcomes for tics. date: 2022-12-26 date_type: published publisher: Wiley-Blackwell official_url: https://doi.org/10.1111/jcpp.13756 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1995244 doi: 10.1111/jcpp.13756 lyricists_name: Bennett, Sophie lyricists_id: SDBEN15 actors_name: Bennett, Sophie actors_id: SDBEN15 actors_role: owner full_text_status: public publication: Journal of Child Psychology and Psychiatry issn: 1469-7610 citation: Hollis, Chris; Hall, Charlotte L; Khan, Kareem; Jones, Rebecca; Marston, Louise; Le Novere, Marie; Hunter, Rachael; ... Murphy, Tara; + view all <#> Hollis, Chris; Hall, Charlotte L; Khan, Kareem; Jones, Rebecca; Marston, Louise; Le Novere, Marie; Hunter, Rachael; Andren, Per; Bennett, Sophie; Brown, Beverley J; Chamberlain, Liam; Davies, E Bethan; Evans, Amber; Kouzoupi, Natalia; McKenzie, Caitlin; Sanderson, Charlotte; Heyman, Isobel; Kilgariff, Joseph; Glazebrook, Cristine; Mataix-Cols, David; Serlachius, Eva; Murray, Elizabeth; Murphy, Tara; - view fewer <#> (2022) Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial. Journal of Child Psychology and Psychiatry 10.1111/jcpp.13756 <https://doi.org/10.1111/jcpp.13756>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10161726/3/Bennett_Child%20Psychology%20Psychiatry%20-%202023%20-%20Hollis%20-%20Long%E2%80%90term%20clinical%20and%20cost%E2%80%90effectiveness%20of%20a%20therapist%E2%80%90supported%20online.pdf