Within-Trial Cost-Effectiveness of an Adherence-Enhancing Educational Intervention for Glaucoma.
Within-Trial Cost-Effectiveness of an Adherence-Enhancing Educational Intervention for Glaucoma.
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DOI：
10.1016/j.ajo.2022.08.011
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发表时间：
2022-12
影响因子：
4.2
通讯作者：
Hung, Anna
中科院分区：
文献类型：
--
作者：
Williams, Andrew M.;Theophanous, Christos;Muir, Kelly W.;Rosdahl, Jullia A.;Woolson, Sandra;Olsen, Maren;Bosworth, Hayden B.;Hung, Anna
评估行为干预改善青光眼药物依从性的试验内成本效益。随机对照试验数据的前瞻性成本效益分析。研究背景是退伍军人事务部（VA）眼科诊所。患者人群包括接受药物治疗的青光眼退伍军人和自我报告的依从性差。参与者被随机分配到一个个性化的教育会议，提醒瓶，以促进药物依从性或控制会议的一般眼睛健康。使用VA管理成本会计系统，从VA付款人的角度评估6个月的成本。使用自举样本进行概率敏感性分析。主要结局指标为通过电子监测器测量的依从性≥80%的参与者比例、总干预和医疗资源成本以及6个月时干预与对照相比的增量成本-效果比。在200名随机参与者中，100名分配到干预组的95名和100名分配到对照组的97名在6个月时有依从性结局，干预组依从性患者的比例高于对照组（0.78 vs 0.40，P < .0001）。所有参与者都有6个月的费用。干预组（n = 100）6个月的总成本为1，149，600美元，对照组（n = 100）为1，298，700美元。因此，在一个假设的100名患者的队列中，干预与成本节约（-149，100美元）相关，并导致另外38名患者实现药物依从性。在6个月时，增强依从性的行为干预是有效的，并且节省了成本。
To assess the within-trial cost-effectiveness of a behavioral intervention to improve glaucoma medication adherence. Prospective cost-effectiveness analysis of randomized, controlled trial data. The study setting was a Veterans Affairs (VA) eye clinic. The patient population comprised veterans with medically treated glaucoma and self-reported poor adherence. Participants were randomized to a personalized educational session with a reminder bottle to promote medication adherence or to a control session on general eye health. Costs were assessed from the perspective of the VA payor at 6 months using the VA Managerial Cost Accounting System. Probabilistic sensitivity analyses were conducted using bootstrapped samples. The main outcome measures were the proportion of participants attaining ≥80% adherence as measured by electronic monitor, total intervention and medical resource costs, and incremental cost-effectiveness ratios comparing intervention to control at 6 months. Of 200 randomized participants, 95 of 100 assigned to the intervention and 97 of 100 assigned to the control had adherence outcomes at 6 months, and the proportion of adherent patients was higher in the intervention group compared to control (0.78 vs 0.40, P < .0001). All participants had costs at 6 months. The total cost at 6 months was $1,149,600 in the intervention group (n = 100) compared to $1,298,700 in the control group (n = 100). Thus, in a hypothetical cohort of 100 patients, the intervention was associated with cost savings (−$149,100) and resulted in 38 additional patients achieving medication adherence. An adherence-enhancing behavioral intervention was effective and cost saving at 6 months.
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DOI：
10.1136/bjophthalmol-2016-308505
发表时间：
2017-06
期刊：
The British journal of ophthalmology
影响因子：
--
作者：
Kim CY;Park KH;Ahn J;Ahn MD;Cha SC;Kim HS;Kim JM;Kim MJ;Kim TW;Kim YY;Lee JW;Park SW;Sohn YH;Sung KR;Yoo C;Cha J;Kim YJ
通讯作者：
Kim YJ
影响因子：
2.7
作者：
Rosdahl, Jullia A.;Hein, Aaron M.;Bosworth, Hayden B.;Woolson, Sandra;Olsen, Maren;Kirshner, Miriam;Hung, Anna;Muir, Kelly W.
通讯作者：
Muir, Kelly W.
影响因子：
3.6
作者：
Hirth, RA;Chernew, ME;Weissert, WG
通讯作者：
Weissert, WG
影响因子：
34.3
作者：
Bourne, Rupert R. A.;Stevens, Gretchen A.;Taylor, Hugh R.
通讯作者：
Taylor, Hugh R.
影响因子：
2.9
作者：
Muir, Kelly W.;Rosdahl, Jullia A.;Bosworth, Hayden B.
通讯作者：
Bosworth, Hayden B.