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: | Christopher Price, Jesse Dawson, Helen Rodgers, Gary Ford, Luke Vale, Scott Wilkes, David Cohen, Laura Ternent, Tracy Finch, Lisa Shaw, Richard Francis, Nina Wilson, Cristina Fernandez-Garcia, Tara Marie Homer, Helen Bosomworth, Lydia Aird, Sreeman Andole, Steven Hogg, Niall Hughes, H I Krebs, Duncan Turner, Frederike Van Wijck |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | BMJ Open, Vol 11, Iss 5 (2021) |
| Druh dokumentu: | article |
| ISSN: | 2020-0420 2044-6055 |
| DOI: | 10.1136/bmjopen-2020-042081 |
| Popis: | Objective To determine whether robot-assisted training is cost-effective compared with an enhanced upper limb therapy (EULT) programme or usual care.Design Economic evaluation within a randomised controlled trial.Setting Four 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.Participants 770 participants aged 18 years or older with moderate or severe upper limb functional limitation from first-ever stroke.Interventions Participants 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 measures Mean 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.Results At 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 (p |
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