Cost-effectiveness of an occupational therapy-led self-management support programme for multimorbidity in primary care
File Type:
PDFItem Type:
Journal ArticleDate:
2022Access:
openAccessCitation:
Gillespie P, Hobbins A, O?Toole L, Connolly D, Boland F, Smith, S, Cost-effectiveness of an occupational therapy-led self-management support programme for multimorbidity in primary care, Family Practice, 2022Download Item:
Optimal RCT_Final_Drfat_TARA.pdf (Accepted for publication (author's copy) - Peer Reviewed) 1.035Mb
Abstract:
Background
Multimorbidity is a major public health concern. Complex interventions, incorporating individualized care plans, may be appropriate for patients with multimorbidity given their individualized and variable needs. There is a dearth of evidence on the cost-effectiveness of complex multimorbidity interventions.
Objective
This study examines the cost-effectiveness of a 6-week occupational therapy-led self-management support programme (OPTIMAL) for adults with multimorbidity.
Methods
Economic evaluation, from a healthcare perspective, was conducted alongside a randomized controlled trial of 149 adults with multimorbidity. Intervention was the OPTIMAL programme with a comparison of usual primary care. Incremental costs, quality-adjusted life years (QALYs) gained, and expected cost-effectiveness were estimated at 6 months and uncertainty was explored using cost-effectiveness acceptability curves.
Results
The intervention was associated with a mean improvement in QALYs gained of 0.031 per patient (P-value: 0.063; 95% confidence intervals [CIs]: −0.002 to 0.063) and a mean reduction in total costs of €2,548 (P-value: 0.114; 95% CIs: −5,606 to 509) per patient. At cost-effectiveness threshold values of €20,000 and €45,000 per QALY, the probability of the intervention being cost-effective was estimated to be 0.951 and 0.958, respectively. The results remained consistent across all subgroups examined.
Conclusions
This study adds to the limited evidence base on the cost-effectiveness of complex interventions for multimorbidity, and highlights the potential for the OPTIMAL programme to be cost-effective. Further studies are warranted to explore the clinical and cost-effectiveness of complex interventions for the multimorbidity patient population, and for subgroups within it.
Trial registration
Trial number: ISRCTN67235963.
Sponsor
Grant Number
Health Research Board (HRB)
HPF-2015-972
Author's Homepage:
http://people.tcd.ie/connoldmhttp://people.tcd.ie/susmith
Description:
PUBLISHED
Author: Connolly, Deirdre; Smith, Susan
Type of material:
Journal ArticleCollections:
Series/Report no:
Family PracticeAvailability:
Full text availableKeywords:
Multimorbidity, Complex Interventions, Cost EffectivenessSubject (TCD):
Ageing , Inclusive Society , COST-EFFECTIVENESS ANALYSIS , Chronic disease self-management , Health-related Quality of Life , Occupational Therapy Primary CareHandle:
http://hdl.handle.net/2262/98123Licences: