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Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial

OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of an individually tailored intervention consisting of motivational counselling and text message reminders to reduce sedentary behaviour in comparison with usual lifestyle in patients with rheumatoid arthritis (RA). METHODS: RA...

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Autores principales: Sørensen, Jan, Esbensen, Bente Appel, Aadahl, Mette, Hetland, Merete Lund, Thomsen, Tanja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301809/
https://www.ncbi.nlm.nih.gov/pubmed/35853676
http://dx.doi.org/10.1136/rmdopen-2022-002304
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author Sørensen, Jan
Esbensen, Bente Appel
Aadahl, Mette
Hetland, Merete Lund
Thomsen, Tanja
author_facet Sørensen, Jan
Esbensen, Bente Appel
Aadahl, Mette
Hetland, Merete Lund
Thomsen, Tanja
author_sort Sørensen, Jan
collection PubMed
description OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of an individually tailored intervention consisting of motivational counselling and text message reminders to reduce sedentary behaviour in comparison with usual lifestyle in patients with rheumatoid arthritis (RA). METHODS: RA patients (n=150) were randomised to the intervention or control group. Costs of the intervention and healthcare utilisation during a 22-month follow-up period were reported. Outcomes were objectively measured as 24 hours/7 days sitting time and self-reported Health Assessment Questionnaire (HAQ) and EQ-5D scores at baseline, and 16 weeks, 10 and 22 months after baseline. Cost-effectiveness was reported as incremental cost-effectiveness ratios and statistical uncertainty presented as cost-effectiveness acceptability curves. RESULTS: The intervention cost was estimated at €387 per participant. The mean incremental 22-month healthcare cost was €−1165 (95% bootstrap CI −5613 to 3283). An incremental 20%-point of the participants (CI 10.4% to 29.6%) reduced their daily sitting time more than 50 min and 36%-point reported better HAQ scores (change>0.22). The time-weighted health utilities (quality-adjusted life years (QALYs)) increased by 0.10 (CI 0.02 to 0.18) and 0.11 (CI 0.04 to 0.19) for EQ-5D index and EQ-VAS, respectively. The intervention dominated usual lifestyle by offering better outcomes and lower costs. With a threshold value of €30 000/QALY the intervention has a probability of 95% of being cost-effective. CONCLUSION: This protocolised cost-effectiveness analysis showed that an individually tailored intervention aimed at reducing sedentary behaviour in patients with RA is improving participants’ 22-month health status and reducing healthcare costs. These results suggest that the intervention should be implemented in routine rheumatology care. TRIAL REGISTRATION NUMBER: NCT01969604.Trial registration number
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spelling pubmed-93018092022-08-11 Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial Sørensen, Jan Esbensen, Bente Appel Aadahl, Mette Hetland, Merete Lund Thomsen, Tanja RMD Open Rheumatoid Arthritis OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of an individually tailored intervention consisting of motivational counselling and text message reminders to reduce sedentary behaviour in comparison with usual lifestyle in patients with rheumatoid arthritis (RA). METHODS: RA patients (n=150) were randomised to the intervention or control group. Costs of the intervention and healthcare utilisation during a 22-month follow-up period were reported. Outcomes were objectively measured as 24 hours/7 days sitting time and self-reported Health Assessment Questionnaire (HAQ) and EQ-5D scores at baseline, and 16 weeks, 10 and 22 months after baseline. Cost-effectiveness was reported as incremental cost-effectiveness ratios and statistical uncertainty presented as cost-effectiveness acceptability curves. RESULTS: The intervention cost was estimated at €387 per participant. The mean incremental 22-month healthcare cost was €−1165 (95% bootstrap CI −5613 to 3283). An incremental 20%-point of the participants (CI 10.4% to 29.6%) reduced their daily sitting time more than 50 min and 36%-point reported better HAQ scores (change>0.22). The time-weighted health utilities (quality-adjusted life years (QALYs)) increased by 0.10 (CI 0.02 to 0.18) and 0.11 (CI 0.04 to 0.19) for EQ-5D index and EQ-VAS, respectively. The intervention dominated usual lifestyle by offering better outcomes and lower costs. With a threshold value of €30 000/QALY the intervention has a probability of 95% of being cost-effective. CONCLUSION: This protocolised cost-effectiveness analysis showed that an individually tailored intervention aimed at reducing sedentary behaviour in patients with RA is improving participants’ 22-month health status and reducing healthcare costs. These results suggest that the intervention should be implemented in routine rheumatology care. TRIAL REGISTRATION NUMBER: NCT01969604.Trial registration number BMJ Publishing Group 2022-07-19 /pmc/articles/PMC9301809/ /pubmed/35853676 http://dx.doi.org/10.1136/rmdopen-2022-002304 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Rheumatoid Arthritis
Sørensen, Jan
Esbensen, Bente Appel
Aadahl, Mette
Hetland, Merete Lund
Thomsen, Tanja
Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial
title Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial
title_full Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial
title_fullStr Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial
title_full_unstemmed Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial
title_short Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial
title_sort cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial
topic Rheumatoid Arthritis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301809/
https://www.ncbi.nlm.nih.gov/pubmed/35853676
http://dx.doi.org/10.1136/rmdopen-2022-002304
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