TY - JOUR
T1 - Cost-effectiveness of a graded exercise therapy program for patients with chronic shoulder complaints
AU - Geraets, J.J.X.R.
AU - Goossens, M.E.J.B.
AU - de Bruijn, C.P.C.
AU - de Groot, I.
AU - Köke, A.J.A.
AU - Pelt, R.A.
AU - van der Heijden, G.J.
AU - Dinant, G.J.
AU - van Heuvel, W.J.A.
PY - 2006/1/1
Y1 - 2006/1/1
N2 - Objectives: The present study evaluated the cost-effectiveness of a behavioral graded exercise therapy (GET) program compared with usual care (UC) in terms of the performance of daily activities by patients with chronic shoulder complaints in primary care. Methods: A total of 176 patients were randomly assigned either to GET ( n =87) or to UC ( n =89). Clinical outcomes (main complaints, shoulder disability [SDQ] and generic health-related quality of life [EQ-5D], and costs [intervention costs, direct health care costs, direct non?health-related costs, and indirect costs]) were assessed during the 12-week treatment period and at 52 weeks of follow-up. Results: Results showed that GET was more effective than UC in restoring daily activities as assessed by the main complaints instrument after the 12-week treatment period ( p =.049; mean difference, 7.5; confidence interval [CI], 0.0?15.0). These effects lasted for at least 52 weeks ( p =.025; mean difference 9.2; CI, 1.2?17.3). No statistically significant differences were found on the SDQ or EQ5D. GET significantly reduced direct health care costs ( p =.000) and direct non?health care costs ( p =.029). Nevertheless, total costs during the 1-year follow-up period were significantly higher ( p =.001; GET=?530 versus UC=?377) due to the higher costs of the intervention. Incremental cost-effectiveness ratios for the main complaints (0?100), SDQ (0?100), and EQ-5D (?1.0?1.0) were ?17, ?74, and ?5,278 per unit of improvement, respectively. Conclusions: GET proved to be more effective in the short- and long-term and reduces direct health care costs and direct non?health care costs but is associated with higher costs of the intervention itself.
AB - Objectives: The present study evaluated the cost-effectiveness of a behavioral graded exercise therapy (GET) program compared with usual care (UC) in terms of the performance of daily activities by patients with chronic shoulder complaints in primary care. Methods: A total of 176 patients were randomly assigned either to GET ( n =87) or to UC ( n =89). Clinical outcomes (main complaints, shoulder disability [SDQ] and generic health-related quality of life [EQ-5D], and costs [intervention costs, direct health care costs, direct non?health-related costs, and indirect costs]) were assessed during the 12-week treatment period and at 52 weeks of follow-up. Results: Results showed that GET was more effective than UC in restoring daily activities as assessed by the main complaints instrument after the 12-week treatment period ( p =.049; mean difference, 7.5; confidence interval [CI], 0.0?15.0). These effects lasted for at least 52 weeks ( p =.025; mean difference 9.2; CI, 1.2?17.3). No statistically significant differences were found on the SDQ or EQ5D. GET significantly reduced direct health care costs ( p =.000) and direct non?health care costs ( p =.029). Nevertheless, total costs during the 1-year follow-up period were significantly higher ( p =.001; GET=?530 versus UC=?377) due to the higher costs of the intervention. Incremental cost-effectiveness ratios for the main complaints (0?100), SDQ (0?100), and EQ-5D (?1.0?1.0) were ?17, ?74, and ?5,278 per unit of improvement, respectively. Conclusions: GET proved to be more effective in the short- and long-term and reduces direct health care costs and direct non?health care costs but is associated with higher costs of the intervention itself.
U2 - 10.1017/S0266462306050860
DO - 10.1017/S0266462306050860
M3 - Article
SN - 0266-4623
VL - 22
SP - 76
EP - 83
JO - International Journal of Technology Assessment in Health Care
JF - International Journal of Technology Assessment in Health Care
IS - 1
ER -