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Cost-effectiveness of two online interventions supporting self-care for eczema for parents/carers and young people

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2024年1月9日

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  • Tracey H. Sach,
  • Mary Onoja,
  • Holly Clarke,
  • Miriam Santer,
  • Ingrid Muller,
  • Taeko Becque,
  • Beth Stuart,
  • Julie Hooper,
  • Mary Steele,
  • Sylvia Wilczynska,
  • Matthew J. Ridd,
  • Amanda Roberts,
  • Amina Ahmed,
  • Lucy Yardley,
  • Paul Little,
  • Kate Greenwell,
  • Katy Sivyer,
  • Jacqui Nuttall,
  • Gareth Griffiths,
  • Sandra Lawton,
  • Sinéad M. Langan,
  • Laura Howells,
  • Paul Leighton,
  • Hywel C. Williams,
  • Kim S. Thomas

摘要

Objective

To estimate the cost-effectiveness of online behavioral interventions (EczemaCareOnline.org.uk) designed to support eczema self-care management for parents/carers and young people from an NHS perspective.

Methods

Two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specified confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomized controlled trials, recruiting through primary care. Trial 1 recruited 340 parents/carers of children aged 0–12 years and Trial 2 337 young people aged 13–25 years with eczema scored ≥ 5 on Patient-Oriented Eczema Measure (POEM). Participants were randomized (1:1) to online intervention plus usual care or usual care alone. Resource use, collected via medical notes review, was valued using published unit costs in UK £Sterling 2021. Quality-of-life was elicited using proxy CHU-9D in Trial 1 and self-report EQ-5D-5L in Trial 2.

Results

The intervention was dominant (cost saving and more effective) with a high probability of cost-effectiveness (> 68%) in most analyses. The exception was the complete case cost–utility analysis for Trial 1 (omitting participants with children aged < 2), with adjusted incremental cost savings of -£34.15 (95% CI  – 104.54 to 36.24) and incremental QALYs of – 0.003 (95% CI  – 0.021 to 0.015) producing an incremental cost per QALY of £12,466. In the secondary combined (Trials 1 and 2) cost-effectiveness analysis, the adjusted incremental cost was -£20.35 (95% CI  – 55.41 to 14.70) with incremental success (≥ 2-point change on POEM) of 10.3% (95% CI 2.3–18.1%).

Conclusion

The free at point of use online eczema self-management intervention was low cost to run and cost-effective.

Trial registration

This trial was registered prospectively with the ISRCTN registry (ISRCTN79282252). URL www.EczemaCareOnline.org.uk.