Comparing the effectiveness and cost-effectiveness of self-management interventions in four high-priority chronic conditions in Europe (COMPAR-EU): a research protocol

Abstract

IntroductionPopulation ageing and increasing chronic illness burden have sparked interest in innovative care models. While self-management interventions (SMIs) are drawing increasing attention, evidence of their efficacy is mostly based on pairwise meta-analysis, generally derived from randomised controlled trials comparing interventions versus a control or no intervention. As such, relevant efficacy data for comparisons among different SMIs that can be applied to specific chronic conditions are missing. Therefore, the relevance of the available evidence for decision-making at clinical, organisational and policy levels is limited.AimTo identify, compare and rank the most effective and cost-effective SMIs for adults with four high-priority chronic conditions: type 2 diabetes, obesity, chronic obstructive pulmonary disease,and heart failure.Methods and analysisAll activities will be conducted as part of the cost-effectiveness of self-management interventions in four high-priority chronic conditions in Europe(COMPAR-EU, Comparing effectiveness of self-management interventions in 4 high priority chronic diseases inEurope) Project, an European Union (EU)-funded project designed to bridge the gap between current knowledge and practice on SMIs. In the first phase of the project, we will develop and validate a taxonomy, and a Core Outcome Set for each condition. These activities will inform a series of systematic review and network meta-analysis about the effectiveness of SMIs. We will also perform a cost-effectiveness analysis of the most effective SMIs and an evaluation of contextual factors. We will finally develop tailored decision-making tools for the different relevant stakeholders.Ethics and disseminationEthical approval was obtained from the local ethics committee (University Institute for Primary Care Research - IDIAP Jordi Gol). All patients and other stakeholders will provide informed consent prior to participation. This project has been funded by the EU Horizon 2020 research and innovation programme (grant agreement no. 754936). Results will be of interest to relevant stakeholder groups (patients, professionals, managers, policymakers and industry), and will be disseminated in a tailored multi-pronged approach that will include deployment of an interactive platform.

The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews

“…Moreover, the selected themes may help to delineate other COS for related interventions or similar populations. Our findings will also inform the development of decision-making tools for the COMPAR-EU project [ 7 ], including evidence for decision frameworks to develop recommendations and decision aids.…”

“…In this context, making informed decisions about the use of SM at clinical, organisational, and policy levels is still challenging. To bridge this gap, the project COMPAR-EU was designed to identify the most effective and cost-effective SM interventions for four high-priority diseases in Europe: type 2 diabetes mellitus (T2DM), obesity, chronic obstructive pulmonary disease (COPD), and heart failure (HF) [ 7 ].…”

Self-management interventions for adults living with Chronic Obstructive Pulmonary Disease (COPD): The development of a Core Outcome Set for COMPAR-EU project

“…The COS for SMIs in COPD patients was developed in accordance with the Core Outcome Measures for Effectiveness Trials (COMET) Handbook [ 14 ] and the Core Outcome Set-STAndards for Development (COS-STAD) guidelines [ 15 ]. This study was conducted according to a protocol previously published [ 16 ]. The COMPAR-EU COS approach involved four interlinked stages that are described below and summarized in Fig 1 .…”

The development of a core outcomes set for self‐management interventions for patients living with obesity

“…We developed and published our protocol in BMJ Open. 6 The COS-STAR guidelines were used to ensure the reporting of this study. 15 The development of this COS for SMIs for patients living with obesity…”