Cost-utility analysis of multimodal occupational therapy in patients with thumb base osteoarthritis

Tveter, Anne Therese; Kleven, Linn; Østerås, Nina; Nossum, Randi; Eide, Ruth Else Mehl; Klokkeide, Åse; Matre, Karin Hoegh; Olsén, Monika Fagevik; Andreassen, Øyvor; Kjeken, Ingvild

doi:10.1016/j.joca.2020.02.683

Cited by 2 publications

(12 citation statements)

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“…In total, 45 unique studies were included: 25 completed EEs [ 29 – 34 , 37 – 55 ] and 20 ongoing studies, of which 11 were published as protocol articles [ 56 – 66 ] and nine as registration records [ 67 – 75 ]. Two completed EEs were only published as conference abstracts [ 53 , 54 ] and two as dissertations [ 37 , 49 ]. A total of 54 email enquiries were sent to the study authors, of which 23 were answered (response rate 42.6%).…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, adherence and safety/feasibility outcomes can be found in Additional file 1 : Appendix 12. Two EEs had adherence rates of less than 35% [ 48 , 51 ] and in three EEs, drop-out and/or adverse event rates were notably higher in the prehabilitation groups [ 47 , 48 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Four trial-based EEs [ 37 , 42 , 48 , 53 ] reported data on the primary outcome, i.e. cost-effectiveness based on CUA (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of prehabilitation prior to elective surgery: a systematic review of economic evaluations

Rombey,

Eckhardt,

Kiselev

et al. 2023

BMC Med

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Background Prehabilitation aims at enhancing patients’ functional capacity and overall health status to enable them to withstand a forthcoming stressor like surgery. Our aim was to synthesise the evidence on the cost-effectiveness of prehabilitation for patients awaiting elective surgery compared with usual preoperative care. Methods We searched PubMed, Embase, the CRD database, ClinicalTrials.gov, the WHO ICTRP and the dissertation databases OADT and DART. Studies comparing prehabilitation for patients with elective surgery to usual preoperative care were included if they reported cost outcomes. All types of economic evaluations (EEs) were included. The primary outcome of the review was cost-effectiveness based on cost–utility analyses (CUAs). The risk of bias of trial-based EEs was assessed with the Cochrane risk of bias 2 tool and the ROBINS-I tool and the credibility of model-based EEs with the ISPOR checklist. Methodological quality of full EEs was assessed using the CHEC checklist. The EEs’ results were synthesised narratively using vote counting based on direction of effect. Results We included 45 unique studies: 25 completed EEs and 20 ongoing studies. Of the completed EEs, 22 were trial-based and three model-based, corresponding to four CUAs, three cost-effectiveness analyses, two cost–benefit analyses, 12 cost–consequence analyses and four cost-minimization analyses. Three of the four trial-based CUAs (75%) found prehabilitation cost-effective, i.e. more effective and/or less costly than usual care. Overall, 16/25 (64.0%) EEs found prehabilitation cost-effective. When excluding studies of insufficient credibility/critical risk of bias, this number reduced to 14/23 (60.9%). In 8/25 (32.0%), cost-effectiveness was unclear, e.g. because prehabilitation was more effective and more costly, and in one EE prehabilitation was not cost-effective. Conclusions We found some evidence that prehabilitation for patients awaiting elective surgery is cost-effective compared to usual preoperative care. However, we suspect a relevant risk of publication bias, and most EEs were of high risk of bias and/or low methodological quality. Furthermore, there was relevant heterogeneity depending on the population, intervention and methods. Future EEs should be performed over a longer time horizon and apply a more comprehensive perspective. Trial registration PROSPERO CRD42020182813.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of prehabilitation prior to elective surgery: a systematic review of economic evaluations

Rombey,

Eckhardt,

Kiselev

et al. 2023

BMC Med

View full text Add to dashboard Cite

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“…In comparison to the results of the overview by McIsaac et al 2022 (7), the included EEs on cancer surgery showed more bene cial results regarding morbidity (30-32, 41, 44, 53) and mortality (39,48,53), and the included EEs on orthopaedic surgery showed more bene cial results on health-related quality of life (HrQoL) (35,40,45,46,51). Apart from that, results were comparable but, overall, the included EEs' results appear more bene cial suggesting a risk of publication bias.…”

Section: Publication Biasmentioning

confidence: 87%

“…Cost-effectiveness depended on the population and intervention, with certain groups (e.g., cancer-or high-risk patients) and programmes (e.g., shorter, home-based prehabilitation) resulting more frequently in bene t. Among the included EEs, there was a high variability in populations, whose underlying diseases and surgeries differed in concept (e.g., restoration in orthopaedic surgery and cure in cancer surgery). It is possible that for orthopaedic patients, the restoring character of the surgery might be the crucial element in the recovery of both groups, although the modalities of prehabilitation may also serve as a conservative therapy option for certain orthopaedic patients, delaying or even eliminating the need for surgery (47,51). Of course, for other patient groups, cure through prehabilitation is not possible, e.g., for cancer patients whose disease cannot be improved in itself by prehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of prehabilitation prior to elective surgery: A systematic review of economic evaluations

Rombey,

Eckhardt,

Kiselev

et al. 2023

Preprint

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Background Prehabilitation aims at enhancing patients’ functional capacity and overall health status to enable them to withstand a forthcoming stressor like surgery. Our aim was to synthesise the evidence on the cost-effectiveness of prehabilitation for patients awaiting elective surgery compared with usual preoperative care. Methods We searched PubMed, Embase, the CRD database, ClinicalTrials.gov, the WHO ICTRP and the dissertation databases OADT and DART. Studies comparing prehabilitation for patients with elective surgery to usual preoperative care were included if they reported cost outcomes. All types of economic evaluations (EEs) were included regardless of design, analysis type and completion status. The primary outcome of the review was cost-effectiveness based on cost-utility analyses (CUAs). The risk of bias of trial-based EEs was assessed with the Cochrane Risk of Bias 2 tool and the ROBINS-I tool, and the credibility of model-based EEs with the ISPOR checklist. Methodological quality of full EEs was assessed using the CHEC checklist. The EEs’ results were synthesised narratively using vote counting based on direction of effect. Results We included 45 unique studies: 25 completed EEs and 20 ongoing studies. Among the completed EEs, there were 22 trial-based EEs, and three model-based EEs, corresponding to four CUAs, three cost-effectiveness analyses, two cost-benefit analyses, 12 cost-consequence analyses and four cost-minimization analyses. Three of the four trial-based CUAs (75%) found prehabilitation cost-effective. Overall, 16/25 (64.0%) EEs found prehabilitation cost-effective based on direction of effects. When excluding studies of insufficient credibility/critical risk of bias, this number reduced to 14/23 (60.9%). In 8/25 (32.0%) cost-effectiveness was unclear, and in one EE prehabilitation was not cost-effective. Discussion We found some evidence that prehabilitation for patients awaiting elective surgery is cost-effective compared to usual preoperative care. However, we suspect a relevant risk of publication bias, and most EEs were of high risk of bias and/or low methodological quality. Furthermore, there was relevant heterogeneity depending on the population, intervention, and methods. Future EEs should be performed over a longer time horizon and apply a more comprehensive perspective. Funding information and systematic review registration Funding: Innovationsausschuss of the Federal Joint Committee (G-BA) (01NVF18024). Registration: PROSPERO CRD42020182813.

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Cost-utility analysis of multimodal occupational therapy in patients with thumb base osteoarthritis

Cited by 2 publications

References 0 publications

Cost-effectiveness of prehabilitation prior to elective surgery: a systematic review of economic evaluations

Cost-effectiveness of prehabilitation prior to elective surgery: a systematic review of economic evaluations

Cost-effectiveness of prehabilitation prior to elective surgery: A systematic review of economic evaluations

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