Cost-effectiveness of SPACE for COPD© Delivered as a Maintenance Programme following Pulmonary Rehabilitation (PR).

Le résumé fourni par la source

Introduction: The benefits of PR are known to decline by 12months after the initial programme. Previous maintenance studies have been labour intensive and concentrated on secondary care healthcare utilisation. We aimed to investigate whether SPACE for COPD©, a light-touch self-management programme, was cost-effective following PR. We have previously presented the clinical outcomes of this trial1. Methods: We conducted a prospective, multicentre, single-blind RCT. COPD patients were randomised to usual care(control) or SPACE. The intervention was a home-based manual + 4group sessions delivered over 12months. NHS resource use, personal expenditure + societal costs were recorded over 1year. Changes in HRQoL were recorded using EQ-5D-5L. Missing values were imputed using Bayesian mixed model with confounders. Results:116 participants were recruited. Baseline characteristics of the 2 groups were: control (51% male, aged 71.8 years, median MRC 3, mean pack years 44.5, mean BMI 28.3) and SPACE (65% male, aged 71.8 years, median MRC 3, mean pack years 41.1, mean BMI 29.1). At 12-months the intervention group retained a significantly higher EQ-5D-5L utility value compared to controls [.7609 (.0348) SPACE vs .6738 (.0348) control. The QALY difference was 0.0871 (p=0.04). The mean difference between groups in NHS costs was £139.63; driven by a reduction in GP visits and prescription costs in the intervention group. Conclusion: At 12 months, EQ-5D-5L was significantly higher in the intervention group. The light-touch SPACE maintenance programme was cost-effective at 12-months, driven by reduced primary care NHS costs. 1https://thorax.bmj.com/content/79/Suppl_2/A90.2.abstract

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.