Cost-effectiveness of a two-layer compression bandage versus standard bandage following total knee arthroplasty.

Autor:	Ronaldson SJ; Department of Health Sciences, York Trials Unit, University of York, York, UK., Cook E; Department of Health Sciences, York Trials Unit, University of York, York, UK., Mitchell A; Department of Health Sciences, York Trials Unit, University of York, York, UK., Fairhurst CM; Department of Health Sciences, York Trials Unit, University of York, York, UK., Reed M; Northumbria Healthcare NHS Foundation Trust, Ashington, UK., Martin BC; Department of Health Sciences, York Trials Unit, University of York, York, UK., Torgerson DJ; Department of Health Sciences, York Trials Unit, University of York, York, UK.
Jazyk:	angličtina
Zdroj:	Bone & joint open [Bone Jt Open] 2024 Jul 05; Vol. 5 (7), pp. 550-559. Date of Electronic Publication: 2024 Jul 05.
DOI:	10.1302/2633-1462.57.BJO-2023-0153.R1
Abstrakt:	Aims: To assess the cost-effectiveness of a two-layer compression bandage versus a standard wool and crepe bandage following total knee arthroplasty, using patient-level data from the Knee Replacement Bandage Study (KReBS). Methods: A cost-utility analysis was undertaken alongside KReBS, a pragmatic, two-arm, open label, parallel-group, randomized controlled trial, in terms of the cost per quality-adjusted life year (QALY). Overall, 2,330 participants scheduled for total knee arthroplasty (TKA) were randomized to either a two-layer compression bandage or a standard wool and crepe bandage. Costs were estimated over a 12-month period from the UK NHS perspective, and health outcomes were reported as QALYs based on participants' EuroQol five-dimesion five-level questionnaire responses. Multiple imputation was used to deal with missing data and sensitivity analyses included a complete case analysis and testing of costing assumptions, with a secondary analysis exploring the inclusion of productivity losses. Results: The base case analysis found participants in the compression bandage group accrued marginally fewer QALYs, on average, compared with those in the standard bandage group (reduction of 0.0050 QALYs (95% confidence interval (CI) -0.0051 to -0.0049)), and accumulated additional mean costs (incremental cost of £52.68 per participant (95% CI 50.56 to 54.80)). Findings remained robust to assumptions tested in sensitivity analyses, although considerable uncertainty surrounded the outcome estimates. Conclusion: Use of a two-layer compression bandage is marginally less effective in terms of health-related quality of life, and more expensive when compared with a standard bandage following TKA, so therefore is unlikely to provide a cost-effective option. Competing Interests: All authors report no competing interests. (© 2024 Ronaldson et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu