Economic evaluation of robot-assisted training versus an enhanced upper limb therapy programme or usual care for patients with moderate or severe upper limb functional limitation due to stroke: results from the RATULS randomised controlled trial
| Autor: | Helen Rodgers, Tracy Finch, Richard Francis, Scott Wilkes, Luke Vale, Jesse Dawson, David L Cohen, Laura Ternent, Tara Homer, Steven Hogg, Hermano Igo Krebs, Sreeman Andole, Gary A. Ford, Helen Bosomworth, Frederike van Wijck, Duncan L. Turner, Lisa Shaw, Nina Wilson, Christopher Price, Cristina Fernandez-Garcia, Lydia Aird, Niall Hughes |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Total cost Cost-Benefit Analysis Psychological intervention State Medicine law.invention Upper Extremity 03 medical and health sciences 0302 clinical medicine Health Economics Willingness to pay Randomized controlled trial law Health care London Medicine Humans 030212 general & internal medicine Stroke health care economics and organizations Health economics business.industry rehabilitation medicine General Medicine Robotics medicine.disease stroke B900 Economic evaluation Physical therapy Quality of Life stroke medicine Quality-Adjusted Life Years business 030217 neurology & neurosurgery |
| Zdroj: | BMJ Open, Vol 11, Iss 5 (2021) BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectiveTo determine whether robot-assisted training is cost-effective compared with an enhanced upper limb therapy (EULT) programme or usual care.DesignEconomic evaluation within a randomised controlled trial.SettingFour National Health Service (NHS) centres in the UK: Queen’s Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust; Northwick Park Hospital, London Northwest Healthcare NHS Trust; Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde; and North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust.Participants770 participants aged 18 years or older with moderate or severe upper limb functional limitation from first-ever stroke.InterventionsParticipants randomised to one of three programmes provided over a 12-week period: robot-assisted training plus usual care; the EULT programme plus usual care or usual care.Main economic outcome measuresMean healthcare resource use; costs to the NHS and personal social services in 2018 pounds; utility scores based on EQ-5D-5L responses and quality-adjusted life years (QALYs). Cost-effectiveness reported as incremental cost per QALY and cost-effectiveness acceptability curves.ResultsAt 6 months, on average usual care was the least costly option (£3785) followed by EULT (£4451) with robot-assisted training being the most costly (£5387). The mean difference in total costs between the usual care and robot-assisted training groups (£1601) was statistically significant (pConclusionsThe cost-effectiveness analysis suggested that neither robot-assisted training nor EULT, as delivered in this trial, were likely to be cost-effective at any of the cost per QALY thresholds considered.Trial registration numberISRCTN69371850. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|