Early neurologically focused follow-up after cardiac arrest is cost-effective: A trial-based economic evaluation

Véronique R M Moulaert; Mariëlle Goossens; Irene L C Heijnders; Jeanine A Verbunt; Caroline M van Heugten

doi:10.1016/j.resuscitation.2016.06.015

Early neurologically focused follow-up after cardiac arrest is cost-effective: A trial-based economic evaluation

Véronique R M Moulaert^*, Mariëlle Goossens, Irene L C Heijnders, Jeanine A Verbunt, Caroline M van Heugten

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.

INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.

METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.

RESULTS: Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54% - 76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.

CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.

TRIAL REGISTRATION: ISRCTN74835019.

Original language	English
Pages (from-to)	30–36
Number of pages	7
Journal	Resuscitation
Volume	106
DOIs	https://doi.org/10.1016/j.resuscitation.2016.06.015
Publication status	Published - Sept 2016

Keywords

Cardiac arrest
Follow-up
Intervention
Economic evaluation
Cost-effectiveness
QUALITY-OF-LIFE
TELEPHONE INTERVENTION
STAND STILL
HEAD-INJURY
SURVIVORS
HEALTH
CAREGIVERS
THERAPY
IMPACT
EQ-5D

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10.1016/j.resuscitation.2016.06.015

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Cite this

@article{806ab0b76c0843c7afc1f1f37686e248,

title = "Early neurologically focused follow-up after cardiac arrest is cost-effective: A trial-based economic evaluation",

abstract = "OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.RESULTS: Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54% - 76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.TRIAL REGISTRATION: ISRCTN74835019.",

keywords = "Cardiac arrest, Follow-up, Intervention, Economic evaluation, Cost-effectiveness, QUALITY-OF-LIFE, TELEPHONE INTERVENTION, STAND STILL, HEAD-INJURY, SURVIVORS, HEALTH, CAREGIVERS, THERAPY, IMPACT, EQ-5D",

author = "Moulaert, {V{\'e}ronique R M} and Mari{\"e}lle Goossens and Heijnders, {Irene L C} and Verbunt, {Jeanine A} and Heugten, {Caroline M van}",

note = "Copyright {\textcopyright} 2016. Published by Elsevier Ireland Ltd.",

year = "2016",

month = sep,

doi = "10.1016/j.resuscitation.2016.06.015",

language = "English",

volume = "106",

pages = "30–36",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Early neurologically focused follow-up after cardiac arrest is cost-effective

T2 - A trial-based economic evaluation

AU - Moulaert, Véronique R M

AU - Goossens, Mariëlle

AU - Heijnders, Irene L C

AU - Verbunt, Jeanine A

AU - Heugten, Caroline M van

PY - 2016/9

Y1 - 2016/9

N2 - OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.RESULTS: Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54% - 76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.TRIAL REGISTRATION: ISRCTN74835019.

AB - OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.RESULTS: Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54% - 76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.TRIAL REGISTRATION: ISRCTN74835019.

KW - Cardiac arrest

KW - Follow-up

KW - Intervention

KW - Economic evaluation

KW - Cost-effectiveness

KW - QUALITY-OF-LIFE

KW - TELEPHONE INTERVENTION

KW - STAND STILL

KW - HEAD-INJURY

KW - SURVIVORS

KW - HEALTH

KW - CAREGIVERS

KW - THERAPY

KW - IMPACT

KW - EQ-5D

U2 - 10.1016/j.resuscitation.2016.06.015

DO - 10.1016/j.resuscitation.2016.06.015

M3 - Article

C2 - 27350371

SN - 0300-9572

VL - 106

SP - 30

EP - 36

JO - Resuscitation

JF - Resuscitation

ER -