P207 Outstanding abstract EFFECTIVENESS OF A 24 MONTH INTERDISCIPLINARY COMMUNITY-BASED COPD LIFESTYLE PROGRAM (INTERCOM) IN PATIENTS WITH MODERATE COPD

Wetering, C.R. van; Hoogendoorn, Martine; Mol, Stijn J.M.; Mölken, Maureen P.M.H. Rutten-van; Schols, A.M.W.J.

doi:10.1016/s1744-1161(08)70270-9

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“…From the combined results of the clinical analyses published elsewhere [13][14][15] and the cost-effectiveness analyses presented here, we conclude that compared to usual care, the INTERCOM programme resulted in significant improvements in SGRQ total score and several exercise performance and dyspnoea measures at a cost increase of J2,751 per patient. In terms of costs per QALY, the programme is moderately costeffective.…”

Section: Discussionmentioning

confidence: 60%

“…This CEA was performed alongside a 2-yr randomised controlled trial evaluating the effect of an INTERdisciplinary COMmunity-based COPD management programme (INTERCOM) compared with usual care. Full clinical results of this trial have been reported elsewhere [13][14][15]. In brief, results over the total 2-yr period showed that there were significantly better effects in the INTERCOM group than for usual care in St George's Respiratory Questionnaire (SGRQ) total score, Medical Research Council dysnoea score, 6-min walk distance (6MWD) and cycle endurance time in a constant work rate test at 70% of peak exercise capacity.…”

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confidence: 94%

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Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Hoogendoorn¹,

Wetering²,

Schols³

et al. 2009

Eur Respir J

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The study aimed to estimate the cost-effectiveness of interdisciplinary communitybased chronic obstructive pulmonary disease (COPD) management in patients with COPD.We conducted a cost-effectiveness analysis alongside a 2-yr randomised controlled trial, in which 199 patients with less advanced airflow obstruction and impaired exercise capacity were assigned to the INTERCOM programme or usual care. The INTERCOM programme consisted of exercise training, education, nutritional therapy and smoking cessation counselling offered by community-based physiotherapists and dieticians and hospital-based respiratory nurses. Allcause resource use during 2 yrs was obtained by self-report and from hospital and pharmacy records. Health outcomes were the St George's Respiratory Questionnaire (SGRQ), exacerbations and quality-adjusted life years (QALYs).The INTERCOM group had 30% (95% CI 3-56%) more patients with a clinically relevant improvement in SGRQ total score, 0.08 (95% CI -0.01-0.18) more QALYs per patient, but a higher mean number of exacerbations, 0.84 (95% CI -0.07-1.78). Mean total 2-yr costs were J2,751 (95% CI -J632-J6,372) higher for INTERCOM than for usual care, which resulted in an incremental cost-effectiveness ratio of J9,078 per additional patient with a relevant improvement in SGRQ or J32,425 per QALY.INTERCOM significantly improved disease-specific quality of life, but did not affect exacerbation rate. The cost per QALY ratio was moderate, but within the range of that generally considered to be acceptable.

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Section: Discussionmentioning

confidence: 60%

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confidence: 94%