Cost-effectiveness of automated telephone outreach in patients with lung disease

描述(由申请人提供)： 花生(电话教育关于新的或使用不足的疗法)试验是一项正在进行的、由NHLBI资助的随机、对照、有效性研究，它使用交互式语音电话应答(IVR)技术作为一种低成本干预措施，以提高治疗依从性。在14,000多名受试者中的初步证据表明，IVR干预具有积极的效果，因此我们现在的目标是通过使用试验数据和对参与者的进一步纵向跟踪数据，对干预进行全面的经济评估，从而扩展这项母项研究。对这种干预的成本和相对性价比进行正式和严格的分析，对于在知情的情况下将调查结果转化为其他情况至关重要。母公司研究(花生)包括一项成本分析，将提供关于开发、实施和在其他地点复制IVR干预的成本的良好信息。我们使用这些辅助基金的主要具体目标是开发和改进一个决策模型，该模型可以用来估计父母试验的成本和收益。此外，我们的目标是估计IVR技术的投资回报(即成本补偿)，使用信息价值框架估计和评估生活质量和效用变化、生产率变化和提供商负担。我们的分析将从付款人的角度进行。我们将构建一个决策模型(马尔可夫模型)。决策模型将主要基于从父母试验中获得的估计，但也将包括从患者调查中获得的进一步数据，以及从文献中获得的事件发生率估计，以及对患有哮喘和COPD的KPNW成员的额外数据分析。我们将对父母研究中包括的大约12,000名个人进行调查；这些调查结果将为决策模型提供过渡概率，并将提供与干预相关的生活质量估计(公用事业)和生产力变化。我们的结果将允许决策者访问关键信息，通过将结果纳入可在疾病状态和干预措施中进行比较的指标(成本/QALY)，明确详细说明实施IVR系统所带来的权衡。在医疗保健预算有限的时代，这种跨疾病州的比较很重要；如果资金花在一种干预上，它们就不能用于其他(可能更有效的)用途。投资回报率将使决策者能够评估干预的可负担性。我们的研究将与母研究并行进行，并将利用项目管理、数据分析师和研究人员努力存在的相当大的规模经济。我们计划在18个月内完成这项研究，与家长试验同时进行。公共卫生相关性：这项研究是一项随机研究的扩展，该研究正在测试自动交互电话在提高哮喘和其他肺部疾病患者的服药依从性方面的效果。我们将对自动电话的成本效益(效率)进行评估。(摘要结束)

DESCRIPTION (provided by applicant): The PEANUT (Phone Education About New or Underused Therapies) Trial is an ongoing, NHLBI-funded randomized, controlled, effectiveness study that uses interactive voice-telephone response (IVR) technology as a low-cost intervention to enhance therapeutic adherence. Preliminary evidence in more than 14,000 subjects suggests a positive effect of the IVR intervention, so we now aim to extend this parent study by performing a full economic evaluation of the intervention using data from the trial and further longitudinal follow-up data on the participants. A formal and rigorous analysis of the costs and relative value for money of this intervention is crucial to the informed translation of findings to other settings. The parent study (PEANUT) includes a cost analysis that will provide good information on the costs of developing, implementing and replicating the IVR intervention at other sites. Our primary specific aim with these ancillary funds is to develop and refine a decision model that can be used to estimate the costs and benefits from the parent trial. Additionally, we aim to estimate the return-on-investment of IVR technology (i.e. cost-offsets), estimate and value quality of life and utility changes, productivity changes, and provider burden using a value of information framework. Our analysis will take the payer perspective. We will construct a decision model (Markov model). The decision model will be populated largely from estimates gained from the parent trial, but will also include further data gained from patient survey, and event rate estimates from the literature and additional data analysis on KPNW members with asthma and COPD. We will conduct a survey of about 12,000 individuals included in the parent study; these survey results will inform transition probabilities for the decision model, and will provide quality of life estimates (utilities) and productivity changes associated with the intervention. Our results will allow decision makers access to critical information that explicitly detail the trade-offs that come with implementing the IVR system by putting the results into a metric (cost/QALY) that is comparable across disease sates and interventions. This comparison across disease states is important in the era of constrained budgets in health care; if monies are spent on one intervention, they are not available for other (potentially more efficient) uses. The return-on-investment will allow decision makers to assess the affordability of the intervention. Our study will be carried out in parallel to the parent study, and will take advantage of the considerable economies of scale that exist with project management, data analyst, and investigator effort. We plan to complete the study within an 18-month period, to run concurrently with the parent trial. PUBLIC HEALTH RELEVANCE: This study is an extension of a randomized study that is testing the effect of automated, interactive telephone calls on increasing medication adherence in patients with asthma and other lung diseases. We will carry out an evaluation of the cost-effectiveness (efficiency) of the automated phone calls. (End of Abstract)