Cost-Effectiveness of eRAPID eHealth Intervention for Symptom Management During Chemotherapy.

Autor:	Dawkins B; Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom., Absolom K; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom.; Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom., Hewison J; Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom., Warrington L; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom., Hudson E; Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom., Holch P; Psychology, School of Humanities and Social Sciences, City Campus, Leeds Beckett University, Leeds, United Kingdom., Carter R; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom., Gibson A; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom.; Psychology, School of Humanities and Social Sciences, City Campus, Leeds Beckett University, Leeds, United Kingdom., Holmes M; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom., Rogers Z; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom., Dickinson S; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom., Morris C; Independent Cancer Patients Voices, Brighton, United Kingdom., Woroncow B; Research Advisory Group to Patient-Centred Outcomes Research at Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom., Brown J; Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom., Hulme C; Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom.; Department of Health & Community Science, University of Exeter, St Luke's Campus, Exeter, United Kingdom., Velikova G; Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom.; Psychology, School of Humanities and Social Sciences, City Campus, Leeds Beckett University, Leeds, United Kingdom.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2024 Apr; Vol. 20 (4), pp. 581-590. Date of Electronic Publication: 2024 Jan 24.
DOI:	10.1200/OP.23.00498
Abstrakt:	Purpose: A randomized controlled trial of online symptom monitoring during chemotherapy with electronic patient self-Reporting of Adverse-events: Patient Information and aDvice (eRAPID) system found improved symptom control and patient self-efficacy, without increasing hospital admissions and visits. The aim of this study was to evaluate the cost-effectiveness of the eRAPID eHealth intervention compared with usual care for patients receiving systemic treatment for colorectal, breast, or gynecologic cancers in the United Kingdom. Methods: An embedded economic evaluation was conducted alongside the trial evaluating the effectiveness of eRAPID from health care provider and societal perspectives. Costs and quality-adjusted life-years (QALYs) of patients were compared over 18 weeks of the trial. Incremental cost-effectiveness ratios (ICERs) were estimated and compared with the National Institute for Health and Care Excellence cost-effectiveness threshold. Uncertainty around the ICER was explored using nonparametric bootstrapping and sensitivity analyses. Follow-up data were collected 12-months after random assignment for a subset of the study sample to conduct exploratory analysis of potential longer-term effects. Results: Patients in the eRAPID group had the highest QALY gain and lowest costs over 18 weeks. Although differences were small and not statistically significant, eRAPID had a 55%-58% probability of being more cost-effective than usual care. Patient out-of-pocket costs were lower in the eRAPID group, indicating eRAPID may help patients access support needed within the National Health Service. Exploratory 12-months analysis showed small differences in costs and QALYs, with higher QALY gains in the eRAPID group but also higher costs. Exploratory subgroup analysis by disease status indicated that the eRAPID intervention was cost-effective for patients with early-stage cancers but not for patients with metastatic disease. Conclusion: Despite small differences in QALYs and costs, the analyses show potential cost-effectiveness of online symptom monitoring, when added to usual care, particularly during adjuvant systemic treatment for early-stage cancers.
Databáze:	MEDLINE
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