Preprint
Feasibility, Effectiveness, and Cost-utility of Implementing a Reconsolidation-Based Trauma Treatment in the Aftermath of the November 15 Paris Terrorist Attacks
medRxiv, Vol.9 October 2025
Cold Spring Harbor Laboratory Press
2025
Appears in Thompson Institute Research Collection
Abstract
We report on the feasibility, effectiveness, and cost-utility of implementing evidence-based PTSD treatment to quickly enhance the capacities of a French public hospital network, in the weeks after the November 15 Paris attacks. A 2-arm, multicentric preference clinical trial and economic-evaluation compared the use of Reconsolidation Therapy (RT) to treatment-as-usual (TAU) for 332 adults, mostly with post-traumatic stress disorder (PTSD). RT involves recalling trauma under propranolol during a weekly 25-minute session for six consecutive weeks. Feasibility endpoints included the number of trained hospital personnel over two days and the number of participants choosing RT as their preferred treatment modality. The primary effectiveness endpoint was the delta scores in PTSD symptoms from baseline to Week 52. Cost-utility was evaluated by comparing RT to TAU. A large number of therapists (n = 160) were trained at various hospital sites over two days, and more participants opted for RT (n = 262) than TAU (n = 70), supporting feasibility endpoints. After 1 year, the mean PTSD symptom score decreased by 38.14 points (SD = 0.10) in the RT group and by 35.02 (SD = 1.68) for TAU (p = .297), indexing significant improvement in both groups. A significant difference of 5.11 points (SD = 2.50) in favor of RT (p = .041) emerged at Week 7, suggesting a faster initial recovery with RT vs. TAU. RT had a 55.4% probability of being the more effective and cheaper treatment compared to only 8.4% for TAU, outperforming TAU with a point-estimate saving of 27 150€ per quality-adjusted life year (QALY). Annual sick leave costs were 4 147€ (95%CI: 3 394 - 5 012) for RT versus 7 386€ (95%CI: 5 416 - 10 340) for TAU (p = 0.01). Following massive trauma exposure, it is achievable to train mental health staff over 2 days in providing efficient evidence-based and cost-effective PTSD treatment. Findings await replication.
Details
- Title
- Feasibility, Effectiveness, and Cost-utility of Implementing a Reconsolidation-Based Trauma Treatment in the Aftermath of the November 15 Paris Terrorist Attacks
- Authors
- Alain Brunet (Corresponding Author) - University of the Sunshine Coast, Queensland, Thompson InstituteIsabelle Durand-Zaleski - Assistance Publique – Hôpitaux de ParisRedwan Maatoug - Assistance Publique – Hôpitaux de ParisLina El-Houari - Assistance Publique – Hôpitaux de ParisMélanie Voyer - Centre Hospitalier Henri LaboritNathalie Girault - Assistance Publique – Hôpitaux de ParisKhalid Kalalou - Unité de Recherche Clinique Côte d'AzurLaurent Gugenheim - Hôpital PasteurNathalie Dzierzynski - Assistance Publique – Hôpitaux de ParisLouis Jehel - Centre Hospitalier Universitaire Amiens-PicardieMaud Rötharmel - Centre Hospitalier du RouvrayFarah Hodeib - Assistance Publique – Hôpitaux de ParisAlexis Bourla - Assistance Publique – Hôpitaux de ParisJohan Laverre - Assistance Publique – Hôpitaux de ParisIsis Hanafy - Université Paris-Est Marne-la-ValléeEmmanuelle Castaigne - Assistance Publique – Hôpitaux de ParisAnaël Ayrolles - Pitié-Salpêtrière HospitalBernard Marc - Université Paris-Est Marne-la-ValléeMacarena Cuenca - Centre Hospitalier Sainte-AnnePatrice Louville - Assistance Publique – Hôpitaux de ParisVirginie Buisse - Centre hospitalier Sainte-Marie Rodez (France)Francois Ducrocq - Université de LilleMarie-Odile Krebs - Université Paris DescartesDominique Januel - Unité de Recherche Clinique Côte d'AzurStéphane Mouchabac - Assistance Publique – Hôpitaux de ParisOlivier Guillin - InsermGuillaume Vaiva - Université de LilleZia Ounsa - Unité de Recherche Clinique Côte d'AzurAnne Bissery - Unité de Recherche Clinique Côte d'AzurGaëlle Abgrall - Assistance Publique – Hôpitaux de ParisMichel Benoit - Hôpital PasteurAlicia Le Bras - Assistance Publique – Hôpitaux de ParisNematollah Jaafari - Université de PoitiersCiara Treacy - University of the Sunshine Coast, Queensland, Thompson InstituteCandice Estellat - InsermBruno Millet (Corresponding Author) - Assistance Publique – Hôpitaux de Paris
- Publication details
- medRxiv, Vol.9 October 2025
- Publisher
- Cold Spring Harbor Laboratory Press
- Date published
- 2025
- DOI
- 10.1101/2025.10.08.25337544
- Grant note
- This study was funded by Assistance Publique - Hôpitaux de Paris, Fondation Assistance Publique - Hopitaux de Paris and MSD Avenir
- Organisation Unit
- Healthy Ageing Research Cluster; Thompson Institute
- Language
- English
- Record Identifier
- 991192344502621
- Output Type
- Preprint
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