Cost-Effectiveness of 2 Models of Pessary Care for Pelvic Organ Prolapse: Findings From the TOPSY Randomized Controlled Trial
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Le résumé fourni par la source
OBJECTIVES: Pelvic organ prolapse is the descent of one or more reproductive organs from their normal position, causing associated negative symptoms. One conservative treatment option is pessary management. This study aimed to to investigate the cost-effectiveness of pessary self-management (SM) when compared with clinic-based care (CBC). A decision analytic model was developed to extend the economic evaluation. METHODS: A randomized controlled trial with health economic evaluation. The SM group received a 30-minute SM teaching session, information leaflet, 2-week follow-up call, and a local helpline number. The CBC group received routine outpatient pessary appointments, determined by usual practice. The primary outcome for the cost-effectiveness analysis was incremental cost per quality-adjusted life year (QALY), 18 months post-randomization. Uncertainty was handled using nonparametric bootstrap analysis. In addition, a simple decision analytic model was developed using the trial data to extend the analysis over a 5-year period. RESULTS: There was no significant difference in the mean number of QALYs gained between SM and CBC (1.241 vs 1.221), but mean cost was lower for SM (£578 vs £728). The incremental net benefit estimated at a willingness to pay of £20 000 per QALY gained was £564, with an 80.8% probability of cost-effectiveness. The modeling results were consistent with the trial analysis: the incremental net benefit was estimated as £4221, and the probability of SM being cost-effective at 5 years was 69.7%. CONCLUSIONS: Results suggest that pessary SM is likely to be cost-effective. The decision analytic model suggests that this result is likely to persist over longer durations.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Cost-Effectiveness of 2 Models of Pessary Care for Pelvic Organ Prolapse: Findings From the TOPSY Randomized Controlled Trial
- Date Crossref
- 01/07/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Glasgow Caledonian University Yunus Centre for Social Business and Health pays non établi dans la noticeUniversité ou école supérieure
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Manchester University NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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University of Stirling pays non établi dans la noticeUniversité ou école supérieure
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South Tees Hospitals NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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NHS Greater Glasgow and Clyde pays non établi dans la noticeÉtablissement de santé
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University of Edinburgh Edinburgh Clinical Trials Unit pays non établi dans la noticeUniversité ou école supérieure
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Croydon University Hospital pays non établi dans la noticeÉtablissement de santé
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Faculty of Health Sciences and Sport pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Health Sciences & Sport pays non établi dans la noticeUniversité ou école supérieure
Yunus Centre for Social Business and Health — Glasgow Caledonian University, Manchester University NHS Foundation Trust et University of Stirling, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.