Cost-effectiveness of supported self-management for CFS/ME patients in primary care

Background: Nurse led self-help treatments for people with chronic fatigue syndrome/myalgic encephalitis (CFS/ME) have been shown to be effective in reducing fatigue but their cost-effectiveness is unknown. Methods: Cost-effectiveness analysis conducted alongside a single blind randomised con...

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Main Authors: Richardson, Gerry, Epstein, David, Chew-Graham, Carolyn, Dowrick, Christopher, Bentall, Richard P., Morriss, Richard K., Peters, Sarah, Riste, Lisa, Lovell, Karina, Dunn, Graham, Wearden, Alison J.
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Published: BioMed Central 2013
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Online Access:https://eprints.nottingham.ac.uk/2634/
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author Richardson, Gerry
Epstein, David
Chew-Graham, Carolyn
Dowrick, Christopher
Bentall, Richard P.
Morriss, Richard K.
Peters, Sarah
Riste, Lisa
Lovell, Karina
Dunn, Graham
Wearden, Alison J.
author_facet Richardson, Gerry
Epstein, David
Chew-Graham, Carolyn
Dowrick, Christopher
Bentall, Richard P.
Morriss, Richard K.
Peters, Sarah
Riste, Lisa
Lovell, Karina
Dunn, Graham
Wearden, Alison J.
author_sort Richardson, Gerry
building Nottingham Research Data Repository
collection Online Access
description Background: Nurse led self-help treatments for people with chronic fatigue syndrome/myalgic encephalitis (CFS/ME) have been shown to be effective in reducing fatigue but their cost-effectiveness is unknown. Methods: Cost-effectiveness analysis conducted alongside a single blind randomised controlled trial comparing pragmatic rehabilitation (PR) and supportive listening (SL) delivered by primary care nurses, and treatment as usual (TAU) delivered by the general practitioner (GP) in North West England. A within trial analysis was conducted comparing the costs and quality adjusted life years (QALYs) measured within the time frame of the trial. 296 patients aged 18 and over with CFS/ME diagnosed using the Oxford criteria were included in the cost-effectiveness analysis. Results: Treatment as usual is less expensive and leads to better patient outcomes compared with Supportive Listening. Treatment as usual is also less expensive than Pragmatic Rehabilitation. PR was effective at reducing fatigue in the short term, but the impact of the intervention on QALYs was uncertain. However, based on the results of this trial, PR is unlikely to be cost-effective in this patient population. Conclusions: This analysis does not support the introduction of SL. Any benefits generated by PR are unlikely to be of sufficient magnitude to warrant recommending PR for this patient group on cost-effectiveness grounds alone. However, dissatisfaction with current treatment options means simply continuing with ‘treatment as usual’ in primary care is unlikely to be acceptable to patients and practitioners.
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spelling nottingham-26342020-05-04T16:35:23Z https://eprints.nottingham.ac.uk/2634/ Cost-effectiveness of supported self-management for CFS/ME patients in primary care Richardson, Gerry Epstein, David Chew-Graham, Carolyn Dowrick, Christopher Bentall, Richard P. Morriss, Richard K. Peters, Sarah Riste, Lisa Lovell, Karina Dunn, Graham Wearden, Alison J. Background: Nurse led self-help treatments for people with chronic fatigue syndrome/myalgic encephalitis (CFS/ME) have been shown to be effective in reducing fatigue but their cost-effectiveness is unknown. Methods: Cost-effectiveness analysis conducted alongside a single blind randomised controlled trial comparing pragmatic rehabilitation (PR) and supportive listening (SL) delivered by primary care nurses, and treatment as usual (TAU) delivered by the general practitioner (GP) in North West England. A within trial analysis was conducted comparing the costs and quality adjusted life years (QALYs) measured within the time frame of the trial. 296 patients aged 18 and over with CFS/ME diagnosed using the Oxford criteria were included in the cost-effectiveness analysis. Results: Treatment as usual is less expensive and leads to better patient outcomes compared with Supportive Listening. Treatment as usual is also less expensive than Pragmatic Rehabilitation. PR was effective at reducing fatigue in the short term, but the impact of the intervention on QALYs was uncertain. However, based on the results of this trial, PR is unlikely to be cost-effective in this patient population. Conclusions: This analysis does not support the introduction of SL. Any benefits generated by PR are unlikely to be of sufficient magnitude to warrant recommending PR for this patient group on cost-effectiveness grounds alone. However, dissatisfaction with current treatment options means simply continuing with ‘treatment as usual’ in primary care is unlikely to be acceptable to patients and practitioners. BioMed Central 2013-01-18 Article PeerReviewed Richardson, Gerry, Epstein, David, Chew-Graham, Carolyn, Dowrick, Christopher, Bentall, Richard P., Morriss, Richard K., Peters, Sarah, Riste, Lisa, Lovell, Karina, Dunn, Graham and Wearden, Alison J. (2013) Cost-effectiveness of supported self-management for CFS/ME patients in primary care. BMC Family Practice, 14 (Januar). 9/1-9/9. ISSN 1471-2296 Cost-effectiveness Primary care CFS/ME Self-management Supportive listening Pragmatic rehabilitation http://www.biomedcentral.com/1471-2296/14/12 doi:10.1186/1471-2296-14-12 doi:10.1186/1471-2296-14-12
spellingShingle Cost-effectiveness
Primary care
CFS/ME
Self-management
Supportive listening
Pragmatic rehabilitation
Richardson, Gerry
Epstein, David
Chew-Graham, Carolyn
Dowrick, Christopher
Bentall, Richard P.
Morriss, Richard K.
Peters, Sarah
Riste, Lisa
Lovell, Karina
Dunn, Graham
Wearden, Alison J.
Cost-effectiveness of supported self-management for CFS/ME patients in primary care
title Cost-effectiveness of supported self-management for CFS/ME patients in primary care
title_full Cost-effectiveness of supported self-management for CFS/ME patients in primary care
title_fullStr Cost-effectiveness of supported self-management for CFS/ME patients in primary care
title_full_unstemmed Cost-effectiveness of supported self-management for CFS/ME patients in primary care
title_short Cost-effectiveness of supported self-management for CFS/ME patients in primary care
title_sort cost-effectiveness of supported self-management for cfs/me patients in primary care
topic Cost-effectiveness
Primary care
CFS/ME
Self-management
Supportive listening
Pragmatic rehabilitation
url https://eprints.nottingham.ac.uk/2634/
https://eprints.nottingham.ac.uk/2634/
https://eprints.nottingham.ac.uk/2634/