Cost-effectiveness of FENO-based and web-based monitoring in paediatric asthma management: a randomised controlled trial.
Thorax
; 71(7): 607-13, 2016 07.
Article
em En
| MEDLINE
| ID: mdl-27048197
ABSTRACT
BACKGROUND:
In children with asthma, web-based monitoring and inflammation-driven therapy may lead to improved asthma control and reduction in medications. However, the cost-effectiveness of these monitoring strategies is yet unknown.OBJECTIVE:
We assessed the cost-effectiveness of web-based monthly monitoring and of 4-monthly monitoring of FENO as compared with standard care.METHODS:
An economic evaluation was performed alongside a randomised controlled multicentre trial with a 1-year follow-up. Two hundred and seventy-two children with asthma, aged 4-18â years, were randomised to one of three strategies. In standard care, treatment was adapted according to Asthma Control Test (ACT) at 4-monthly visits, in the web-based strategy also according to web-ACT at 1â month intervals, and in the FENO-based strategy according to ACT and FENO at 4-monthly visits. Outcome measures were patient utilities, healthcare costs, societal costs and incremental cost per quality-adjusted life year (QALY) gained.RESULTS:
No statistically significant differences were found in QALYs and costs between the three strategies. The web-based strategy had 77% chance of being most cost-effective from a healthcare perspective at a willingness to pay a generally accepted 40â 000/QALY. The FENO-based strategy had 83% chance of being most cost-effective at 40â 000/QALY from a societal perspective.CONCLUSIONS:
Economically, web-based monitoring was preferred from a healthcare perspective, while the FENO-based strategy was preferred from a societal perspective, although in QALYs and costs no statistically significant changes were found as compared with standard care. As clinical outcomes also favoured the web-based and FENO-based strategies, these strategies may be useful additions to standard care. TRIAL REGISTRATION NUMBER Netherlands Trial Register (NTR1995).Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Asma
/
Monitorização Ambulatorial
/
Antiasmáticos
/
Internet
/
Óxido Nítrico
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
Aspecto:
Patient_preference
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Thorax
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Holanda