Brain Behav. 2025 Sep;15(9):e70731. doi: 10.1002/brb3.70731.
ABSTRACT
BACKGROUND: Guided internet-based cognitive behavioral therapy (ICBT) provides an accessible alternative treatment for anorexia nervosa (AN), showing initial feasibility and effectiveness in the short term. However, limited research has explored its long-term outcomes in outpatient settings.
OBJECTIVE: This study investigated the long-term outcomes and cost-effectiveness of guided ICBT in women with AN who were receiving outpatient treatment.
METHODS: This study involved a 3-year follow-up of 11 adult women with AN who received guided ICBT in a previous trial. The Eating Disorder Examination Questionnaire (EDE-Q) and body mass index (BMI) were used as outcomes to assess the severity of AN. A repeated-measures ANOVA was conducted to assess differences in mean outcomes at baseline, post-intervention, and two follow-up time points. The incremental cost-effectiveness ratio was calculated to estimate the cost-effectiveness of this intervention, using quality-adjusted life years (QALYs), derived from the EuroQol 5 Dimension 5-Level (EQ-5D-5L), and costs from publicly available data from the Japanese healthcare system.
RESULTS: From baseline, EDE-Q global scores significantly decreased at the 1-year (d = -0.72) and 3-year follow-ups (d = -0.65), while BMI significantly increased at the 1-year (d = 0.66) and 3-year follow-ups (d = 0.98). The estimated incremental cost-effectiveness ratio was notably low, at approximately JPY 111,000 (US$725) per year.
CONCLUSION: These preliminary results suggest that guided ICBT may be effective in the long term for outpatients with AN. Since the threshold has been JPY 5 million in Japan, the current estimated incremental cost-effectiveness ratio suggests that providing guided ICBT to outpatients with AN is likely to be cost-effective.
PMID:40922447 | DOI:10.1002/brb3.70731
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