Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia

Objective: To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia. Design: Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness rat...

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Main Authors: Humphreys, Ioan, Thomas, Shirley A., Phillips, Ceri, Lincoln, Nadina
Format: Article
Published: SAGE 2015
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Online Access:https://eprints.nottingham.ac.uk/50803/
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author Humphreys, Ioan
Thomas, Shirley A.
Phillips, Ceri
Lincoln, Nadina
author_facet Humphreys, Ioan
Thomas, Shirley A.
Phillips, Ceri
Lincoln, Nadina
author_sort Humphreys, Ioan
building Nottingham Research Data Repository
collection Online Access
description Objective: To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia. Design: Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. Setting: Community. Participants: Participants identified as having low mood on either the Visual Analog Mood Scale sad item (≥50) or Stroke Aphasic Depression Questionnaire Hospital version 21 (SADQH21) (≥6) were recruited. Interventions: Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit. Main measures: Outcomes were assessed at six months after randomisation, blind to group allocation. The costs were assessed from a service use questionnaire. Effectiveness was defined as the change in SADQH21 scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group. The cost analysis was undertaken from the perspective of the UK NHS and Social Services. Results: The greatest difference was in home help costs where there was a saving of £56.20 in the intervention group compared to an increase of £61.40 in the control group. At six months the SADQH21 score for the intervention group was 17.3 compared to the control group value of 20.4. This resulted in a mean increase of 0.7 in the control group, compared to a mean significant different decrease of 6 in the intervention group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH21 was £263. Conclusion: Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up.
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spelling nottingham-508032020-05-04T16:58:02Z https://eprints.nottingham.ac.uk/50803/ Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia Humphreys, Ioan Thomas, Shirley A. Phillips, Ceri Lincoln, Nadina Objective: To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia. Design: Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. Setting: Community. Participants: Participants identified as having low mood on either the Visual Analog Mood Scale sad item (≥50) or Stroke Aphasic Depression Questionnaire Hospital version 21 (SADQH21) (≥6) were recruited. Interventions: Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit. Main measures: Outcomes were assessed at six months after randomisation, blind to group allocation. The costs were assessed from a service use questionnaire. Effectiveness was defined as the change in SADQH21 scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group. The cost analysis was undertaken from the perspective of the UK NHS and Social Services. Results: The greatest difference was in home help costs where there was a saving of £56.20 in the intervention group compared to an increase of £61.40 in the control group. At six months the SADQH21 score for the intervention group was 17.3 compared to the control group value of 20.4. This resulted in a mean increase of 0.7 in the control group, compared to a mean significant different decrease of 6 in the intervention group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH21 was £263. Conclusion: Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up. SAGE 2015-01-01 Article NonPeerReviewed Humphreys, Ioan, Thomas, Shirley A., Phillips, Ceri and Lincoln, Nadina (2015) Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia. Clinical Rehabilitation, 29 (1). pp. 30-41. ISSN 1477-0873 Aphasia clinical evaluation cognitive impairment economic evaluation health status http://journals.sagepub.com/doi/10.1177/0269215514537656 doi:10.1177/0269215514537656 doi:10.1177/0269215514537656
spellingShingle Aphasia
clinical evaluation
cognitive impairment
economic evaluation
health status
Humphreys, Ioan
Thomas, Shirley A.
Phillips, Ceri
Lincoln, Nadina
Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia
title Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia
title_full Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia
title_fullStr Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia
title_full_unstemmed Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia
title_short Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia
title_sort cost analysis of the communication and low mood (calm) randomised trial of behavioural therapy for stroke patients with aphasia
topic Aphasia
clinical evaluation
cognitive impairment
economic evaluation
health status
url https://eprints.nottingham.ac.uk/50803/
https://eprints.nottingham.ac.uk/50803/
https://eprints.nottingham.ac.uk/50803/