BACKGROUND There are no specific national guidelines in England to guide healthcare professionals in how to assess or treat young people with tic disorders. Access to evidence-based treatment, including behavioural therapy, is of limited availability. OBJECTIVES This study examined the economic impact on services arising from a lack of access to appropriate healthcare services for young people with tic disorders, alongside the impact on school attendance. METHODS This study used data from the randomised controlled trial 'ORBIT' (Online Remote Behavioural Intervention for Tics). ORBIT compared online exposure and response prevention behavioural therapy for tics with online psychoeducation and recruited 224 young people aged 9-17 years in England. Here, we explore costs of health service use and school absenteeism from children who participated in the ORBIT trial and present these alongside the economic impact of including ORBIT within a tic service. We supplement ORBIT data with findings from two case studies. FINDINGS The data showed that patients have care from several healthcare professionals and miss school due to accessing care for tics. The case studies suggest that most of these contacts with specialist services are unlikely to be supportive. However, adding ORBIT could save the National Health Service £1 million. CONCLUSIONS Young people with tic disorders are likely to engage in substantial use of healthcare resources because of inadequate care pathways. The availability of an evidence-based online therapy such as ORBIT could save money to the healthcare system. CLINICAL IMPLICATIONS There is a need to improve service provision and develop national guidelines for tic disorders. TRIAL REGISTRATION NUMBER ISRCTN70758207, NCT03483493.

中文翻译：

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患有抽动障碍的儿童和年轻人难以获得诊断和治疗相关的医疗保健利用和成本。


背景 英格兰没有具体的国家指南来指导医疗保健专业人员如何评估或治疗患有抽动障碍的年轻人。获得循证治疗（包括行为疗法）的机会有限。目的 本研究考察了患有抽动障碍的年轻人无法获得适当的医疗保健服务对服务的经济影响，以及对学校出勤率的影响。方法 本研究使用了来自随机对照试验 'ORBIT' （在线远程行为干预抽动） 的数据。ORBIT 将抽搐的在线暴露和反应预防行为疗法与在线心理教育进行了比较，并在英格兰招募了 224 名 9-17 岁的年轻人。在这里，我们探讨了参与 ORBIT 试验的儿童使用卫生服务和缺勤的成本，并介绍了这些以及将 ORBIT 包含在 tic 服务中的经济影响。我们用两个案例研究的结果补充了 ORBIT 数据。发现 数据显示，患者接受了几位医疗保健专业人员的护理，并且由于获得抽搐护理而缺课。案例研究表明，这些与专业服务的联系中的大多数不太可能是支持的。然而，增加 ORBIT 可以为英国国家医疗服务体系节省 100 万英镑。结论 由于护理途径不足，患有抽动障碍的年轻人可能会大量使用医疗保健资源。像 ORBIT 这样的循证在线疗法的可用性可以为医疗保健系统节省资金。临床意义 需要改善服务提供并制定抽动障碍的国家指南。试验注册号 ISRCTN70758207， NCT03483493。