Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing

E. Cereda, C. Klersy, M. Andreola, R. Pisati, J.M.G.A. Schols, R. Caccialanza, F. D'Andrea, the OligoElement Sore Trial (OEST) Study Group

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background & aims The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric–isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation. Methods This economic evaluation – from a local healthcare system perspective – was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach. The primary efficacy endpoint was the percentage of change in PU area at 8 weeks. The cost analysis focused on: the difference in direct medical costs of local PU care between groups and incremental cost-effectiveness ratio (ICER) of nutritional therapy related to significant study endpoints (percentage of change in PU area and ≥40% reduction in PU area at 8 weeks). Results Although the experimental formula was more expensive (mean difference: 39.4 Euros; P < 0.001), its use resulted in money saving with respect to both non-nutritional PU care activities (difference, −113.7 Euros; P = 0.001) and costs of local PU care (difference, −74.3 Euros; P = 0.013). Therefore, given its efficacy it proved to be a cost-effective intervention. The robustness of these results was confirmed by the sensitivity analyses. Conclusion The use of a disease-specific oral nutritional formula not only results in better healing of PUs, but also reduces the costs of local PU care from a local healthcare system perspective
Original languageEnglish
Pages (from-to)246-252
Number of pages7
JournalClinical Nutrition
Volume36
Issue number1
Early online date2 Dec 2015
DOIs
Publication statusPublished - 1 Feb 2017

Keywords

  • Pressure ulcers
  • Oral nutritional support
  • Healing
  • Cost-effectiveness
  • Incremental cost-effectiveness ratio
  • RANDOMIZED CONTROLLED-TRIAL
  • LONG-TERM-CARE
  • ECONOMIC-EVALUATION
  • INTERVENTION
  • MALNUTRITION
  • MANAGEMENT
  • RESIDENTS
  • ADULTS

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