Cost-effectiveness of self-management in asthma: A systematic review of peak flow monitoring interventions

Willems, Dick; Joore, Manuela A.; Hendriks, J. J. E.; Wouters, Emiel F.M.; Severens, Johan L.

doi:10.1017/s026646230605135x

Cited by 23 publications

(20 citation statements)

References 23 publications

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“…Earlier systematic reviews of asthma interventions also highlighted the importance of the quality assessment in studies . One study, in particular, believed their peak flow monitoring intervention was cost‐effective, but could not conclude this due to the study qualities being so low .…”

Section: Discussionmentioning

confidence: 99%

Economic evidence for nonpharmacological asthma management interventions: A systematic review

Crossman-Barnes

Peel

Fong-Soe-Khioe

et al. 2017

Allergy

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Asthma management, education and environmental interventions have been reported as cost‐effective in a previous review (Pharm Pract (Granada), 2014;12:493), but methods used to estimate costs and outcomes were not discussed in detail. This review updates the previous review by providing economic evidence on the cost‐effectiveness of studies identified after 2012, and a detailed assessment of the methods used in all identified studies. Twelve databases were searched from 1990 to January 2016, and studies included economic evaluations, asthma subjects and nonpharmacological interventions written in English. Sixty‐four studies were included. Of these, 15 were found in addition to the earlier review; 53% were rated fair in quality and 47% high. Education and self‐management interventions were the most cost‐effective, in line with the earlier review. Self‐reporting was the most common method used to gather resource‐use data, accompanied by bottom‐up approaches to estimate costs. Main outcome measures were asthma‐related hospitalizations (69%), quality of life (41%) and utility (38%), with AQLQ and the EQ‐5D being the most common questionnaires measured prospectively at fixed time points. More rigorous costing methods are needed with a more common quality of life tool to aid greater replicability and comparability amongst asthma studies.

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Section: Discussionmentioning

confidence: 99%

Economic evidence for nonpharmacological asthma management interventions: A systematic review

Crossman-Barnes

Peel

Fong-Soe-Khioe

et al. 2017

Allergy

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“…61 One SR reported that the use of selfmanagement programs based on peak flow monitoring in patients with asthma was cost-effective or even cost saving. 73 …”

Section: Dementiamentioning

confidence: 99%

Systematic overview of economic evaluations of health-related rehabilitation

Wilsher

Irvine

Hong

et al. 2016

Disability and Health Journal

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“…This performance bias could have been better managed or avoided if the physicians were randomly allocated instead, as was the case in Schermer et al64 Overall, the self-management in this review which involved peak-flow and/or symptoms monitoring was promising and also mostly cost-reducing. However, Willems et al found the cost-effectiveness of this type of management inconclusive 80. Nevertheless, the positive outcomes from a trial-based peak-flow self-management may not be the case in real-life situations if owning a peak-flow meter is a burden to the patients.…”

Section: Data Extraction On Reviewed Studiesmentioning

confidence: 99%

Economic Evaluation of Enhanced Asthma Management: A Systematic Review

Yong

Shafie

2013

Value in Health

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Objectives:To evaluate and compare full economic evaluation studies on the cost-effectiveness of enhanced asthma management (either as an adjunct to usual care or alone) vs. usual care alone.Methods:Online databases were searched for published journal articles in English language from year 1990 to 2012, using the search terms ‘“asthma” AND (“intervene” OR “manage”) AND (“pharmacoeconomics” OR “economic evaluation” OR “cost effectiveness” OR “cost benefit” OR “cost utility”)’. Hand search was done for local publishing. Only studies with full economic evaluation on enhanced management were included (cost consequences (CC), cost effectiveness (CE), cost benefit (CB), or cost utility (CU) analysis). Data were extracted and assessed for the quality of its economic evaluation design and evidence sources.Results:A total of 49 studies were included. There were 3 types of intervention for enhanced asthma management: education, environmental control, and self-management. The most cost-effective enhanced management was a mixture of education and self-management by an integrated team of healthcare and allied healthcare professionals. In general, the studies had a fair quality of economic evaluation with a mean QHES score of 73.7 (SD=9.7), and had good quality of evidence sources.Conclusion:Despite the overall fair quality of economic evaluations but good quality of evidence sources for all data components, this review showed that the delivered enhanced asthma managements, whether as single or mixed modes, were overall effective and cost-reducing. Whilst the availability and accessibility are an equally important factor to consider, the sustainability of the cost-effective management has to be further investigated using a longer time horizon especially for chronic diseases such as asthma.

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Cost-effectiveness of self-management in asthma: A systematic review of peak flow monitoring interventions

Cited by 23 publications

References 23 publications

Economic evidence for nonpharmacological asthma management interventions: A systematic review

Economic evidence for nonpharmacological asthma management interventions: A systematic review

Systematic overview of economic evaluations of health-related rehabilitation

Economic Evaluation of Enhanced Asthma Management: A Systematic Review

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