ORCID Profile
0000-0002-1026-278X
Current Organisation
University of Nottingham
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Publisher: Elsevier BV
Date: 10-2021
Publisher: BMJ
Date: 2019
DOI: 10.1136/BMJOPEN-2018-027583
Abstract: Tourette syndrome and chronic tic disorder are common, disabling childhood-onset conditions. Guidelines recommend that behavioural therapy should be offered as first-line treatment for children with tics. However, there are very few trained behaviour therapists for tics and many patients cannot access appropriate care. This trial investigates whether an internet-delivered intervention for tics can reduce severity of symptoms. This parallel-group, single-blind, randomised controlled superiority trial with an internal pilot will recruit children and young people (aged 9–17 years) with tic disorders. Participants will be randomised to receive 10 weeks of either online, remotely delivered, therapist-supported exposure response prevention behavioural therapy for tics, or online, remotely delivered, therapist-supported education about tics and co-occurring conditions. Participants will be followed up mid-treatment, and 3, 6, 12 and 18 months post randomisation. The primary outcome is reduction in tic severity as measured on the Yale Global Tic Severity Scale total tic severity score. Secondary outcomes include a cost-effectiveness analysis and estimate of the longer-term impact on patient outcomes and healthcare services. An integrated process evaluation will analyse quantitative and qualitative data in order to fully explore the implementation of the intervention and identify barriers and facilitators to implementation. The trial is funded by the National Institute of Health Research (NIHR), Health Technology Assessment (16/19/02). The findings from the study will inform clinicians, healthcare providers and policy makers about the clinical and cost-effectiveness of an internet delivered treatment for children and young people with tics. The results will be submitted for publication in peer-reviewed journals. The study has received ethical approval from North West Greater Manchester Research Ethics Committee (ref.: 18/NW/0079). ISRCTN70758207 and NCT03483493 Pre-results.
Publisher: Elsevier BV
Date: 2021
DOI: 10.2139/SSRN.3777196
Publisher: Wiley
Date: 17-01-2023
DOI: 10.1111/JCPP.13756
Abstract: 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. 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). Two hundred and twenty‐four participants were enrolled: 112 to ERP and 112 to psychoeducation. The s le 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 ( %) 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. 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.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Beverley Brown.