BACKGROUND: An economic evaluation was performed alongside a randomised controlled trial (ISRCTN 74071417) investigating the cost-effectiveness of nurse-led telephone follow-up instead of hospital visits, and of a short educational group programme (EGP) in the first year after breast cancer treatment. METHOD: This economic evaluation (n = 299) compared the one-year costs and the effects of four follow-up strategies: (1) hospital follow-up; (2) nurse-led telephone follow-up; (3) hospital follow-up plus EGP; and (4) nurse-led telephone follow-up plus EGP. Costs were measured using cost diaries and hospital registrations. Quality-adjusted life years (QALYs) were measured using the EQ-5D. Outcomes were expressed in incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves. RESULTS: Hospital follow-up plus EGP yielded most QALYs (0.776), but also incurred the highest mean annual costs (€4914). The ICER of this strategy versus the next best alternative, nurse-led telephone follow-up plus EGP (0.772 QALYs and €3971), amounted to €235.750/QALY. Hospital and telephone follow-up without EGP both incurred higher costs and less QALYs than telephone follow-up plus EGP and were judged inferior. Hospital follow-up plus EGP was not considered cost-effective, therefore, telephone follow-up plus EGP was the preferred strategy. The probability of telephone follow-up plus EGP being cost-effective ranged from 49% to 62% for different QALY threshold values. Secondary and sensitivity analyses showed that results were robust. CONCLUSION:Nurse-led telephone follow-up plus EGP seems an appropriate and cost-effective alternative to hospital follow-up for breast cancer patients during their first year after treatment.
RCT Entities:
BACKGROUND: An economic evaluation was performed alongside a randomised controlled trial (ISRCTN 74071417) investigating the cost-effectiveness of nurse-led telephone follow-up instead of hospital visits, and of a short educational group programme (EGP) in the first year after breast cancer treatment. METHOD: This economic evaluation (n = 299) compared the one-year costs and the effects of four follow-up strategies: (1) hospital follow-up; (2) nurse-led telephone follow-up; (3) hospital follow-up plus EGP; and (4) nurse-led telephone follow-up plus EGP. Costs were measured using cost diaries and hospital registrations. Quality-adjusted life years (QALYs) were measured using the EQ-5D. Outcomes were expressed in incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves. RESULTS: Hospital follow-up plus EGP yielded most QALYs (0.776), but also incurred the highest mean annual costs (€4914). The ICER of this strategy versus the next best alternative, nurse-led telephone follow-up plus EGP (0.772 QALYs and €3971), amounted to €235.750/QALY. Hospital and telephone follow-up without EGP both incurred higher costs and less QALYs than telephone follow-up plus EGP and were judged inferior. Hospital follow-up plus EGP was not considered cost-effective, therefore, telephone follow-up plus EGP was the preferred strategy. The probability of telephone follow-up plus EGP being cost-effective ranged from 49% to 62% for different QALY threshold values. Secondary and sensitivity analyses showed that results were robust. CONCLUSION: Nurse-led telephone follow-up plus EGP seems an appropriate and cost-effective alternative to hospital follow-up for breast cancerpatients during their first year after treatment.
Authors: Jennifer C Thompson; Sara B Cichowski; Rebecca G Rogers; Fares Qeadan; Julissa Zambrano; Cynthia Wenzl; Peter C Jeppson; Gena C Dunivan; Yuko M Komesu Journal: Int Urogynecol J Date: 2019-02-19 Impact factor: 2.894
Authors: Rashid L Bashshur; Gary W Shannon; Brian R Smith; Dale C Alverson; Nina Antoniotti; William G Barsan; Noura Bashshur; Edward M Brown; Molly J Coye; Charles R Doarn; Stewart Ferguson; Jim Grigsby; Elizabeth A Krupinski; Joseph C Kvedar; Jonathan Linkous; Ronald C Merrell; Thomas Nesbitt; Ronald Poropatich; Karen S Rheuban; Jay H Sanders; Andrew R Watson; Ronald S Weinstein; Peter Yellowlees Journal: Telemed J E Health Date: 2014-06-26 Impact factor: 3.536
Authors: Beverley L Høeg; Pernille E Bidstrup; Randi V Karlsen; Anne Sofie Friberg; Vanna Albieri; Susanne O Dalton; Lena Saltbæk; Klaus Kaae Andersen; Trine Allerslev Horsboel; Christoffer Johansen Journal: Cochrane Database Syst Rev Date: 2019-11-21
Authors: Karen M Goldstein; Leah L Zullig; Eric A Dedert; Amir Alishahi Tabriz; Timothy W Brearly; Giselle Raitz; Suchita Shah Sata; John D Whited; Hayden B Bosworth; Adelaide M Gordon; Avishek Nagi; John W Williams; Jennifer M Gierisch Journal: J Gen Intern Med Date: 2018-10-03 Impact factor: 6.473