Ioan Humphreys1, Shirley Thomas2, Ceri Phillips1, Nadina Lincoln3. 1. Swansea Centre for Health Economics, Swansea University, UK. 2. Division of Rehabilitation and Ageing, University of Nottingham, UK shirley.thomas@nottingham.ac.uk. 3. Division of Rehabilitation and Ageing, University of Nottingham, UK.
Abstract
OBJECTIVE: To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia. DESIGN: Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. SETTING: Community. PARTICIPANTS: Participants identified as having low mood on either the Visual Analog Mood Scale sad item (≥50) orStroke Aphasic Depression Questionnaire Hospital version 21 (SADQH21) (≥6) were recruited. INTERVENTIONS: Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit. MAIN MEASURES: Outcomes were assessed at six months after randomisation, blind to group allocation. The costs were assessed from a service use questionnaire. Effectiveness was defined as the change in SADQH21 scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group. The cost analysis was undertaken from the perspective of the UK NHS and Social Services. RESULTS: The greatest difference was in home help costs where there was a saving of £56.20 in the intervention group compared to an increase of £61.40 in the control group. At six months the SADQH21 score for the intervention group was 17.3 compared to the control group value of 20.4. This resulted in a mean increase of 0.7 in the control group, compared to a mean significant different decrease of 6 in the intervention group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH21 was £263. CONCLUSION: Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up.
RCT Entities:
OBJECTIVE: To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for strokepatients with aphasia. DESIGN: Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. SETTING: Community. PARTICIPANTS: Participants identified as having low mood on either the Visual Analog Mood Scale sad item (≥50) or Stroke Aphasic Depression Questionnaire Hospital version 21 (SADQH21) (≥6) were recruited. INTERVENTIONS:Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit. MAIN MEASURES: Outcomes were assessed at six months after randomisation, blind to group allocation. The costs were assessed from a service use questionnaire. Effectiveness was defined as the change in SADQH21 scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group. The cost analysis was undertaken from the perspective of the UK NHS and Social Services. RESULTS: The greatest difference was in home help costs where there was a saving of £56.20 in the intervention group compared to an increase of £61.40 in the control group. At six months the SADQH21 score for the intervention group was 17.3 compared to the control group value of 20.4. This resulted in a mean increase of 0.7 in the control group, compared to a mean significant different decrease of 6 in the intervention group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH21 was £263. CONCLUSION: Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up.
Authors: Leeanne Nicklas; Mairi Albiston; Martin Dunbar; Alan Gillies; Jennifer Hislop; Helen Moffat; Judy Thomson Journal: BMC Health Serv Res Date: 2022-09-07 Impact factor: 2.908