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首页> 外文期刊>International journal of nursing studies >Cost-effectiveness of a nurse facilitated, cognitive behavioural self-management programme compared with usual care using a CBT manual alone for patients with heart failure: Secondary analysis of data from the SEMAPHFOR trial
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Cost-effectiveness of a nurse facilitated, cognitive behavioural self-management programme compared with usual care using a CBT manual alone for patients with heart failure: Secondary analysis of data from the SEMAPHFOR trial

机译：与仅使用CBT手册进行常规治疗的心力衰竭患者相比，护士促进的认知行为自我管理计划的成本效益：SEMAPHFOR试验数据的二次分析

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Objective: To assess the cost-effectiveness of a nurse facilitated, cognitive behavioural self-management programme for patients with heart failure compared with usual care including the un-facilitated access to the same manual, from the perspective of the NHS. Design: Data were obtained from a pragmatic, multi-centre, randomized controlled 'open' trial conducted in seven centres in the UK between 2006 and 2008. Effectiveness was estimated as Quality-Adjusted Life Years. Resource use was measured prospectively on all patients using information provided by patients in postal questionnaires, case-note review, electronic record review and interviews with patients. Unit costs were obtained from the literature and applied to the relevant resource use to estimate total costs. Multiple imputation was used to handle missing data. Results: There were no substantial differences in the utility scores between treatment groups in all follow-up assessments, in the use of medication or outpatient visits and both groups report a similar frequency of contact with health care professionals. After controlling for baseline utility and using imputed dataset, treatment was associated with a reduction in QALY of 0.004 and a additional cost of ￡69.49. The probability that the intervention is cost-effective for thresholds between ￡20,000 and ￡30,000 is around 45%. Conclusions: There is little evidence that the addition of the intervention had any effect on costs or outcomes. The uncertainty around both estimates of cost and effectiveness mean that it is not reasonable to make recommendations based on cost-effectiveness alone.
机译：目的：从NHS的角度，评估护士协助的，认知行为自我管理计划对心力衰竭患者与常规护理（包括无助地使用同一手册）相比的成本效益。设计：数据来自于2006年至2008年间在英国七个中心进行的实用，多中心，随机对照的“开放”试验。有效性被评估为质量调整生命年。使用患者在邮政调查表，案例笔记，电子记录审查和患者访谈中提供的信息，对所有患者的资源使用进行前瞻性测量。单位成本是从文献中获得的，并应用于相关资源使用以估算总成本。多重插补用于处理丢失的数据。结果：在所有后续评估中，在使用药物或门诊就诊时，治疗组之间的效用得分没有实质性差异，并且两组报告的与医疗保健专业人员的接触频率相似。在控制了基准效用并使用估算的数据集后，治疗与QALY降低0.004和增加￡ 69.49有关。对于介于￡ 20,000和￡ 30,000之间的阈值，干预措施具有成本效益的可能性约为45％。结论：几乎没有证据表明增加干预措施对费用或结果有任何影响。成本和效益估算的不确定性意味着仅根据成本效益提出建议是不合理的。

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