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Self-monitoring combined with patient-initiated care in RA patients with low disease activity: cost-effectiveness analysis of an RCT.
Seppen, Bart F; Greuter, Marjolein J E; Wiegel, Jimmy; Ter Wee, Marieke M; Boers, Maarten; Nurmohamed, Michael T; Bos, Wouter H.
Afiliación
  • Seppen BF; Amsterdam Rheumatology and Immunology Center, Reade Rheumatology and Rehabilitation, Amsterdam, The Netherlands.
  • Greuter MJE; Department of Rheumatology and Immunology, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands.
  • Wiegel J; Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit, Amsterdam, Netherlands.
  • Ter Wee MM; Amsterdam Rheumatology and Immunology Center, Reade Rheumatology and Rehabilitation, Amsterdam, The Netherlands.
  • Boers M; Department of Rheumatology and Immunology, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands.
  • Nurmohamed MT; Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit, Amsterdam, Netherlands.
  • Bos WH; Amsterdam Public Health, Methodology, Societal Participation in Health, Amsterdam, The Netherlands.
Rheumatology (Oxford) ; 62(10): 3366-3372, 2023 10 03.
Article en En | MEDLINE | ID: mdl-36799560
OBJECTIVES: Self-monitoring and patient-initiated care (PIC) leads to fewer outpatient clinic visits in patients with established RA with low disease activity (LDA) while healthcare outcomes are similar. This study assesses the cost-effectiveness of PIC with self-monitoring. METHODS: A 12-month randomized controlled trial was performed with 49 patients in the PIC with self-monitoring group (app-group) and 53 in usual care. The usual care group continued with preplanned visits. The app group had one planned follow-up visit after 12 months and monitored their RA disease activity in a smartphone app. Both groups could make additional appointments at liberty. We included adult RA patients with a disease duration of over 2 years, a disease activity score 28 (DAS28) below 3.2 that were stable on medication for at least 6 months. The effect measure, the DAS28, was measured at 12 months and healthcare resource usage and productivity losses were measured at 3, 6, 9 and 12 months. RESULTS: There was no significant difference in mean change of DAS28 (-0.04 mean difference, 95% CI: -0.39, 0.30), nor a statistically significant difference in total costs (mean difference €514, 95% CI:-€266, €3690) in the app group compared with the usual care group. The probability that the app was cost-effective was 0.37 and 0.57 at a willingness-to-pay threshold of 0 and 50 000 €/point improvement DAS28, respectively. CONCLUSION: Although rheumatic care costs were significantly lower in the app group, total costs and effects of PIC with self-monitoring were not different from usual care in RA patients with LDA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención al Paciente / Análisis de Costo-Efectividad Tipo de estudio: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Límite: Adult / Humans Idioma: En Revista: Rheumatology (Oxford) Asunto de la revista: REUMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención al Paciente / Análisis de Costo-Efectividad Tipo de estudio: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Límite: Adult / Humans Idioma: En Revista: Rheumatology (Oxford) Asunto de la revista: REUMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido