Literature DB >> 27580727

Erratum to: 'Quality of life and costs of spasticity treatment in German stroke patients'.

Reinhard Rychlik1, Fabian Kreimendahl2, Nicole Schnur3, Judith Lambert-Baumann3, Dirk Dressler4.   

Abstract

Entities:  

Year:  2016        PMID: 27580727      PMCID: PMC5007227          DOI: 10.1186/s13561-016-0114-6

Source DB:  PubMed          Journal:  Health Econ Rev        ISSN: 2191-1991


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Unfortunately, the original version of this article [1] contained errors. There were formatting errors in the main text and in Tables 1, 2, 3, 4, 5 and 6. These tables have been included correctly below. There will also be an update to correct the errors in the main text.
Table 1

Cost data sources

ItemCost sources
DrugsGerman Rote Liste 2013, web-based research
Ambulatory medical treatmentGerman value measurement (EBM 2000+) and fee regulations for doctors (GOÄ)
Non-pharmacological therapiesAccording to agreements between German health insurance funds and professional organizations
Medical devices / aidsWeb-based research
Hospitalisation and RehabilitationGerman Diagnosis-Related Groups (G-DRG), web- and phone-based research
Nursing home careAccording to German long term care insurance
Reduction in earning capacityAverage payments according to German retirement insurance
Table 2

Patient demography and other baseline characteristics

INCO pretreated N = 67INCO naïve N = 41INCO total N = 108CON N = 110Total N = 218
Gender (m)36 (53.7 %)22 (53.7 %)58 (53.7 %)70 (63.6 %)128 (58.7 %)
Age (years)62.3 (10.7)60.7 (16.0)61.7 (12.9)67.8 (12.7)64.8 (13.1)
Body mass index (kg/m2)26.7 (4.0)26.8 (4.4)26.7 (4.1)27.7 (4.8)27.2 (4.5)
Time since apoplex (years)8.0 (5.6)6.8 (6.1)7.5 (5.8)5.3 (5.1)6.5 (5.6)
Time since spasticity (years)6.9 (6.3)6.0 (6.5)6.6 (6.3)4.9 (5.4)5.7 (5.9)
Concomitant diseases (yes)55 (82.1 %)29 (70.7 %)84 (77.8 %)96 (87.3 %)180 (8.6 %)
Employed (yes)1 (1.5 %)3 (7.3 %)4 (3.7 %)9 (8.2 %)13 (6.0 %)
Retired (yes)58 (96.7 %)39 (97.5 %)87 (94.6 %)86 (86.9 %)173 (90.6 %)
Early retirement due to spasticity (yes)40 (63.5 %)20 (55.6 %)60 (60.6 %)19 (20.4 %)79 (41.1 %)
Reduction in earning capacity due to spasticity (yes)22 (32.9 %)11 (26.8 %)33 (30.6 %)23 (20.9 %)56 (25.7 %)
Level of care (none)12 (17.9 %)10 (24.4 %)22 (20.4 %)37 (35.6 %)59 (27.8 %)
Level 128 (41.8 %)15 (36.6 %)43 (39.8 %)33 (31.7 %)76 (35.8 %)
Level 223 (34.3 %)15 (36.6 %)38 (35.2 %)29 (27.9 %)67 (31.6 %)
Level 34 (6.0 %)1 (2.4 %)5 (4.6 %)5 (4.8 %)10 (4.7 %)

All values are means (± standard deviation) or number of patients (%)

Table 3

Overview of antispastic therapies and measures during the study

IncobotulinumtoxinA group:Antispastic medications except BoNT/A, non-pharmacological therapies and aids
First quarter (n = 108)Second quarter (n = 102)Third quarter (n = 99)Fourth quarter (n = 94)
Oral medication31 (28.7 %)23 (32.4 %)20 (20.2 %)18 (19.1 %)
Physical therapy60 (55.6 %)54 (52.9 %)54 (54.5 %)51 (54.3 %)
Occupational therapy43 (39.8 %)42 (41.2 %)41 (41.4 %)44 (46.8 %)
Speech therapy10 (9.3 %)8 (7.8 %)8 (8.1 %)9 (8.6 %)
Other therapies3 (2.8 %)6 (6.0 %)4 (4.0 %)4 (4.3 %)
Therapeutic aids12 (11.0 %)5 (5.7 %)-1 (1.0 %)
Conventional therapy group:Antispastic medications, non-pharmacological therapies and aids
First quarter (n = 110)Second quarter (n = 98)Third quarter (n = 91)Fourth quarter (n = 84)
Oral medication67 (60.9 %)66 (67.3 %)63 (69.2 %)58 (69.0 %)
Physical therapy68 (61.8 %)59 (60.2 %)54 (54.5 %)52 (61.9 %)
Occupational therapy15 (13.6 %)11 (11.2 %)11 (12.1 %)8 (9.5 %)
Speech therapy5 (4.6 %)5 (5.1 %)5 (5.5 %)4 (4.8 %)
Other therapies3 (2.7 %)5 (5.1 %)-1 (1.2 %)
Therapeutic aids10 (11.0 %)8 (8.2 %)12 (13.2 %)8 (9.5 %)
Table 4

Responder analyses at study end after 1-year of treatment

INCO pretreatedINCO naïveINCO totalCONINCO pretr. vs. CONINCO naïve vs. CONINCO total vs. CON
Shoulder adduction/internal rotation56.473.962.915.5<0.01<0.01<0.01
Shoulder abduction65.510073.019.7<0.01<0.01<0.01
Shoulder elevation66.788.972.720.6<0.01<0.01<0.01
Flexed elbow78.392.983.826.9<0.01<0.01<0.01
Forearm pronation81.473.779.022.0<0.01<0.01<0.01
Flexed wrist82.194.786.226.6<0.01<0.01<0.01
Thumb-in-palm77.881.378.820.0<0.01<0.01<0.01
Clenched fist79.195.284.422.2<0.01<0.01<0.01
Intrinsic-plus-position of the hand73.310078.919.5<0.01<0.01<0.01

Responder rates (%); response was definded as ≥ 1-point improvement on the Ashworth Scale for all treated muscle groups at study end; Fisher´s exact test was used for group comparisons

Table 5

Overview of total costs by cost centers (in €)

INCO n = 93CON n = 83
Ambulatory medical treatment175217
Drugs3,386193
Hospitalizations (including rehabilitation measures)40138
Non-pharmacological therapies1,408998
Medical devices / aids7912
Nursing home care3,0892,203
Total direct costs8,1883,806
Reduction in earning capacity2,081988
Total costs10,2684,794
Table 6

Overview of Cost-utility ratios and ICER

Utility parameterINCOCON
Responder rate in Ashworth Score per clinical pattern Responder rate Cost-utility ratio Responder rate Cost-utility ratio ICER
Shoulder adduction / internal rotation62.9 %16,325 €15.5 %30,929 €11,549 €
Shoulder abduction73.0 %14,066 €19.7 %24,335 €10,271 €
Shoulder elevation72.7 %14,124 €20.6 %23,272 €10,507 €
Flexed elbow83.8 %12,253 €26.9 %17,821 €9,621 €
Pronated forearm79.0 %12,998 €22.0 %21,791 €9,604 €
Flexed wrist86.2 %11,912 €26.6 %18,022 €9,185 €
Thumb-in-palm78.8 %13,031 €20.0 %23,970 €9,310 €
Clenched fist84.4 %12,166 €22.2 %21,595 €8,801 €
Intrinsic-Plus-position (hand)78.9 %13,014 €19.5 %24,585 €9,216 €
Improvement in SF-12 dimension Improvement Cost-utility ratio Improvement Cost-utility ratio ICER
Physical Health7.961,290 €0.835,776 €768 €
Mental Health10.75955 €5.71840 €1,086 €

Incremental Cost-Effectiveness Ratio (ICER) = (Total costs INCO – Total costs CON)/(Utility value INCO – Utility value CON)

Cost data sources Patient demography and other baseline characteristics All values are means (± standard deviation) or number of patients (%) Overview of antispastic therapies and measures during the study Responder analyses at study end after 1-year of treatment Responder rates (%); response was definded as ≥ 1-point improvement on the Ashworth Scale for all treated muscle groups at study end; Fisher´s exact test was used for group comparisons Overview of total costs by cost centers (in €) Overview of Cost-utility ratios and ICER Incremental Cost-Effectiveness Ratio (ICER) = (Total costs INCO – Total costs CON)/(Utility value INCO – Utility value CON)
  1 in total

1.  Quality of life and costs of spasticity treatment in German stroke patients.

Authors:  Reinhard Rychlik; Fabian Kreimendahl; Nicole Schnur; Judith Lambert-Baumann; Dirk Dressler
Journal:  Health Econ Rev       Date:  2016-07-08
  1 in total

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