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Chong, Huey Yi; McNamee, Paul; Bachmair, Eva-Maria; Martin, Kathryn; Aucott, Lorna; Dhaun, Neeraj; Dures, Emma; Emsley, Richard; Gray, Stuart R; Kidd, Elizabeth; Kumar, Vinod; Lovell, Karina; MacLennan, Graeme; Norrie, John; Paul, Lorna; Packham, Jonathan; Ralston, Stuart H; Siebert, Stefan; Wearden, Alison; Macfarlane, Gary; Basu, Neil; Nicol, Amy; Norris, Karen; Mann, Sandra; [...]

Cost-effectiveness of cognitive behavioural and personalized exercise interventions for reducing fatigue in inflammatory rheumatic diseases

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  • Medientyp: E-Artikel
  • Titel: Cost-effectiveness of cognitive behavioural and personalized exercise interventions for reducing fatigue in inflammatory rheumatic diseases
  • Beteiligte: Chong, Huey Yi; McNamee, Paul; Bachmair, Eva-Maria; Martin, Kathryn; Aucott, Lorna; Dhaun, Neeraj; Dures, Emma; Emsley, Richard; Gray, Stuart R; Kidd, Elizabeth; Kumar, Vinod; Lovell, Karina; MacLennan, Graeme; Norrie, John; Paul, Lorna; Packham, Jonathan; Ralston, Stuart H; Siebert, Stefan; Wearden, Alison; Macfarlane, Gary; Basu, Neil; Nicol, Amy; Norris, Karen; Mann, Sandra; [...]
  • Erschienen: Oxford University Press (OUP), 2023
  • Erschienen in: Rheumatology, 62 (2023) 12, Seite 3819-3827
  • Sprache: Englisch
  • DOI: 10.1093/rheumatology/kead157
  • ISSN: 1462-0324; 1462-0332
  • Schlagwörter: Pharmacology (medical) ; Rheumatology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>To estimate the cost-effectiveness of a cognitive behavioural approach (CBA) or a personalized exercise programme (PEP), alongside usual care (UC), in patients with inflammatory rheumatic diseases who report chronic, moderate to severe fatigue.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A within-trial cost-utility analysis was conducted using individual patient data collected within a multicentre, three-arm randomized controlled trial over a 56-week period. The primary economic analysis was conducted from the UK National Health Service (NHS) perspective. Uncertainty was explored using cost-effectiveness acceptability curves and sensitivity analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Complete-case analysis showed that, compared with UC, both PEP and CBA were more expensive [adjusted mean cost difference: PEP £569 (95% CI: £464, £665); CBA £845 (95% CI: £717, £993)] and, in the case of PEP, significantly more effective [adjusted mean quality-adjusted life year (QALY) difference: PEP 0.043 (95% CI: 0.019, 0.068); CBA 0.001 (95% CI: −0.022, 0.022)]. These led to an incremental cost-effectiveness ratio (ICER) of £13 159 for PEP vs UC, and £793 777 for CBA vs UC. Non-parametric bootstrapping showed that, at a threshold value of £20 000 per QALY gained, PEP had a probability of 88% of being cost-effective. In multiple imputation analysis, PEP was associated with significant incremental costs of £428 (95% CI: £324, £511) and a non-significant QALY gain of 0.016 (95% CI: −0.003, 0.035), leading to an ICER of £26 822 vs UC. The estimates from sensitivity analyses were consistent with these results.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The addition of a PEP alongside UC is likely to provide a cost-effective use of health care resources.</jats:p> </jats:sec>