Within-Trial Cost-Effectiveness of an Adherence-Enhancing Educational Intervention for Glaucoma
Copyright © 2022 Elsevier Inc. All rights reserved..
PURPOSE: To assess the within-trial cost-effectiveness of a behavioral intervention to improve glaucoma medication adherence.
DESIGN: Prospective cost-effectiveness analysis of randomized, controlled trial data.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: An adherence-enhancing behavioral intervention was effective and cost saving at 6 months.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:244 |
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| Enthalten in: |
American journal of ophthalmology - 244(2022) vom: 25. Dez., Seite 216-227 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Williams, Andrew M [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 30.11.2022 Date Revised 02.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ajo.2022.08.011 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345205332 |
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| 245 | 1 | 0 | |a Within-Trial Cost-Effectiveness of an Adherence-Enhancing Educational Intervention for Glaucoma |
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| 500 | |a Date Completed 30.11.2022 | ||
| 500 | |a Date Revised 02.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: To assess the within-trial cost-effectiveness of a behavioral intervention to improve glaucoma medication adherence | ||
| 520 | |a DESIGN: Prospective cost-effectiveness analysis of randomized, controlled trial data | ||
| 520 | |a METHODS: 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 | ||
| 520 | |a RESULTS: 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 | ||
| 520 | |a CONCLUSIONS: An adherence-enhancing behavioral intervention was effective and cost saving at 6 months | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 700 | 1 | |a Theophanous, Christos |e verfasserin |4 aut | |
| 700 | 1 | |a Muir, Kelly W |e verfasserin |4 aut | |
| 700 | 1 | |a Rosdahl, Jullia A |e verfasserin |4 aut | |
| 700 | 1 | |a Woolson, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Olsen, Maren |e verfasserin |4 aut | |
| 700 | 1 | |a Bosworth, Hayden B |e verfasserin |4 aut | |
| 700 | 1 | |a Hung, Anna |e verfasserin |4 aut | |
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