Cost-effectiveness of physiotherapy in childhood functional constipation: a randomized controlled trial in primary care.
Fam Pract
; 39(4): 662-668, 2022 07 19.
Article
en En
| MEDLINE
| ID: mdl-35018413
ABSTRACT
OBJECTIVE:
Health care expenditures for children with functional constipation (FC) are high, while conservative management is successful in only 50% of the children. The aim is to evaluate whether adding physiotherapy to conventional treatment (CT) is a cost-effective strategy in the management of children with FC aged 4-18 years in primary care.METHODS:
A cost-effectiveness analysis was performed alongside a randomized controlled trial (RCT) with 8-month follow-up. Costs were assessed from a societal perspective, effectiveness included both the primary outcome (treatment success defined as the absence of FC and no laxative use) and the secondary outcome (absence of FC irrespective of laxative use). Uncertainty was assessed by bootstrapping and cost-effectiveness acceptability curves (CEACs) were displayed.RESULTS:
One hundred and thirty-four children were randomized. The incremental cost-effectiveness ratio (ICER) for one additional successfully treated child in the physiotherapy group compared with the CT group was 24,060 (95% confidence interval [CI] -16,275 to 31,390) and for the secondary outcome 1,221 (95% CI -12,905 to 10,956). Subgroup analyses showed that for children with chronic laxative use the ICER was 2,134 (95% CI -24,975 to 17,192) and 571 (95% CI 11 to 3,566), respectively. At a value of 1,000, the CEAC showed a probability of 0.53 of cost-effectiveness for the primary outcome, and 0.90 for the secondary outcome.CONCLUSIONS:
Physiotherapy added to CT as first-line treatment for all children with FC is not cost-effective compared with CT alone. Future studies should consider the cost-effectiveness of physiotherapy added to CT in children with chronic laxative use. TRIAL REGISTRATION The RCT is registered in the Netherlands Trial Register (NTR4797), on the 8th of September 2014. The first child was enrolled on the 2nd of December 2014. https//www.trialregister.nl/trial/4654.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Modalidades de Fisioterapia
/
Estreñimiento
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Límite:
Child
/
Humans
Idioma:
En
Revista:
Fam Pract
Año:
2022
Tipo del documento:
Article
País de afiliación:
Países Bajos