A Universal Digital Stress Management Intervention for Employees: Randomized Controlled Trial with Health-Economic Evaluation
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In: Journal of Medical Internet Research, Vol. 26, e48481, 22.10.2024.
Research output: Journal contributions › Journal articles › Research › peer-review
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TY - JOUR
T1 - A Universal Digital Stress Management Intervention for Employees
T2 - Randomized Controlled Trial with Health-Economic Evaluation
AU - Freund, Johanna
AU - Smit, Filip
AU - Lehr, Dirk
AU - Zarski, Anna Carlotta
AU - Berking, Matthias
AU - Riper, Heleen
AU - Funk, Burkhardt
AU - Ebert, David Daniel
AU - Buntrock, Claudia
N1 - Publisher Copyright: ©Johanna Freund, Filip Smit, Dirk Lehr, Anna-Carlotta Zarski, Matthias Berking, Heleen Riper, Burkhardt Funk, David Daniel Ebert, Claudia Buntrock. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.10.2024.
PY - 2024/10/22
Y1 - 2024/10/22
N2 - BACKGROUND: Stress is highly prevalent and known to be a risk factor for a wide range of physical and mental disorders. The effectiveness of digital stress management interventions has been confirmed; however, research on its economic merits is still limited. OBJECTIVE: This study aims to assess the cost-effectiveness, cost-utility, and cost-benefit of a universal digital stress management intervention for employees compared with a waitlist control condition within a time horizon of 6 months. METHODS: Recruitment was directed at the German working population. A sample of 396 employees was randomly assigned to the intervention group (n=198) or the waitlist control condition (WLC) group (n=198). The digital stress management intervention included 7 sessions plus 1 booster session, which was offered without therapeutic guidance. Health service use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and an employer's perspective. Costs were related to symptom-free status (PSS-10 [Perceived Stress Scale] score 2 SDs below the study population baseline mean) and quality-adjusted life years (QALYs) gained. The sampling error was handled using nonparametric bootstrapping. RESULTS: From a societal perspective, the digital intervention was likely to be dominant compared with WLC, with a 56% probability of being cost-effective at a willingness-to-pay (WTP) of €0 per symptom-free person gained. At the same WTP threshold, the digital intervention had a probability of 55% being cost-effective per QALY gained relative to the WLC. This probability increased to 80% at a societal WTP of €20,000 per QALY gained. Taking the employer's perspective, the digital intervention showed a probability of a positive return on investment of 78%. CONCLUSIONS: Digital preventive stress management for employees appears to be cost-effective societally and provides a favorable return on investment for employers. TRIAL REGISTRATION: German Clinical Trials Register DRKS00005699; https://drks.de/search/en/trial/DRKS00005699.
AB - BACKGROUND: Stress is highly prevalent and known to be a risk factor for a wide range of physical and mental disorders. The effectiveness of digital stress management interventions has been confirmed; however, research on its economic merits is still limited. OBJECTIVE: This study aims to assess the cost-effectiveness, cost-utility, and cost-benefit of a universal digital stress management intervention for employees compared with a waitlist control condition within a time horizon of 6 months. METHODS: Recruitment was directed at the German working population. A sample of 396 employees was randomly assigned to the intervention group (n=198) or the waitlist control condition (WLC) group (n=198). The digital stress management intervention included 7 sessions plus 1 booster session, which was offered without therapeutic guidance. Health service use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and an employer's perspective. Costs were related to symptom-free status (PSS-10 [Perceived Stress Scale] score 2 SDs below the study population baseline mean) and quality-adjusted life years (QALYs) gained. The sampling error was handled using nonparametric bootstrapping. RESULTS: From a societal perspective, the digital intervention was likely to be dominant compared with WLC, with a 56% probability of being cost-effective at a willingness-to-pay (WTP) of €0 per symptom-free person gained. At the same WTP threshold, the digital intervention had a probability of 55% being cost-effective per QALY gained relative to the WLC. This probability increased to 80% at a societal WTP of €20,000 per QALY gained. Taking the employer's perspective, the digital intervention showed a probability of a positive return on investment of 78%. CONCLUSIONS: Digital preventive stress management for employees appears to be cost-effective societally and provides a favorable return on investment for employers. TRIAL REGISTRATION: German Clinical Trials Register DRKS00005699; https://drks.de/search/en/trial/DRKS00005699.
KW - cost-benefit
KW - cost-effectiveness
KW - cost-utility
KW - economic evaluation
KW - employees
KW - internet-based
KW - return-on-investment
KW - stress management
KW - universal prevention
KW - Health sciences
KW - Informatics
KW - Psychology
UR - http://www.scopus.com/inward/record.url?scp=85207161021&partnerID=8YFLogxK
U2 - 10.2196/48481
DO - 10.2196/48481
M3 - Journal articles
C2 - 39437382
AN - SCOPUS:85207161021
VL - 26
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
SN - 1439-4456
M1 - e48481
ER -