癌症家庭生活干预的成本-效果:与六个月时间框架随机临床试验的经济评估。

IF 2.1 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Lisa Gregersen Oestergaard, Karen la Cour, Line Elisabeth Lindahl-Jacobsen, Åse Brandt, Marc Sampedro Pilegaard
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引用次数: 0

摘要

背景:晚期癌症患者在日常活动中经常面临重大挑战,特别是在他们的家庭环境中,他们大部分时间都在那里度过。癌症家庭生活干预是一项以职业治疗为基础的项目,支持晚期癌症患者在家生活的日常活动。目的:比较六个月以上癌症家庭生活干预与常规治疗的成本-效用和成本-效果。方法:从社会角度进行经济评估,同时进行随机对照试验(ClinicalTrials.gov: NCT02356627)。质量调整生命年(QALYs)和日常生活运动能力的活动反映了结果。费用包括初级和二级卫生保健、家庭护理、辅助设备和参与者的自付费用。共有242名来自丹麦两所大学医院的晚期癌症患者,按1:1的比例随机分为癌症家庭生活干预组或常规护理组。初步分析包括172名随访6个月的参与者。结果:与常规护理相比,干预在QALYs和日常生活运动能力方面均无统计学意义的改善。然而,成本效用分析显示,无论获得的每个QALY的支付意愿阈值如何,干预措施具有成本效益的概率为72%。日常生活运动能力活动的成本效益概率从26%开始增加到58%。敏感性分析支持这些发现。结论:与常规做法相比,癌症家庭生活干预显示出有限的成本效益潜力。成本效用分析显示,成本效益的概率为72%。然而,由于QALYs的微小的、非统计学意义的改善,这些发现应该谨慎地解释。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Cost-Effectiveness of the Cancer Home-Life Intervention: An Economic Evaluation Alongside a Randomized Clinical Trial with a Six-Month Time Frame.

Background: People with advanced cancer often face significant challenges in everyday activities, especially within their home environments, where they spend most of their time. The Cancer Home-Life Intervention is an occupational therapy-based program supporting everyday activities in people with advanced cancer living at home. Aim: To examine the cost-utility and cost-effectiveness of the Cancer Home-Life Intervention compared to usual care over six months. Methods: This economic evaluation with a societal perspective was conducted alongside a randomized controlled trial (ClinicalTrials.gov: NCT02356627). Quality-adjusted life years (QALYs) and activities of daily living motor ability accounted for the outcome. Costs included primary and secondary health care, domestic care, assistive devices, and participants' out-of-pocket costs. A total of 242 adults with advanced cancer were included from two Danish University Hospitals and randomized 1:1 to the Cancer Home-Life Intervention or usual care. Primary analysis included 172 participants alive at six months follow-up. Results: The intervention showed no statistically significant improvement in either QALYs or activities of daily living motor ability compared to usual care. However, the cost-utility analysis revealed a 72% probability of the intervention being cost-effective, regardless of the willingness-to-pay threshold per QALY gained. The probability of cost-effectiveness for activities of daily living motor ability started at 26% and increased to 58%. Sensitivity analyses supported these findings. Conclusion: The Cancer Home-Life Intervention showed limited potential for cost-effectiveness compared to usual practice. The cost-utility analysis revealed a 72% probability of cost-effectiveness. However, these findings should be interpreted cautiously due to small, nonstatistically significant improvements in QALYs.

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来源期刊
Journal of palliative medicine
Journal of palliative medicine 医学-卫生保健
CiteScore
3.90
自引率
10.70%
发文量
345
审稿时长
2 months
期刊介绍: Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments. The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.
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