IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0175272.html
   My bibliography  Save this article

Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial

Author

Listed:
  • Jacqueline J Suijker
  • Janet L MacNeil-Vroomen
  • Marjon van Rijn
  • Bianca M Buurman
  • Sophia E de Rooij
  • Eric P Moll van Charante
  • Judith E Bosmans

Abstract

Objective: To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care. Methods: We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year follow-up. Participants were aged ≥ 70 years and at increased risk of functional decline. Participants in the intervention group (n = 1209) received a comprehensive geriatric assessment and individually tailored multifactorial interventions coordinated by a community-care registered nurse with multiple follow-up visits. The control group (n = 1074) received usual care. Costs were assessed from a healthcare perspective. Outcome measures included disability (modified Katz-Activities of Daily Living (ADL) index score), and quality-adjusted life-years (QALYs). Statistical uncertainty surrounding Incremental Cost-Effectiveness Ratios (ICERs) was estimated using bootstrapped bivariate regression models while adjusting for confounders. Results: There were no statistically significant differences in Katz-ADL index score and QALYs between the two groups. Total mean costs were significantly higher in the intervention group (EUR 6518 (SE 472) compared with usual care (EUR 5214 (SE 338); adjusted mean difference €1457 (95% CI: 572; 2537). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective was 0.14 at a willingness to pay (WTP) of EUR 50,000 per one point improvement on the Katz-ADL index score and 0.04 at a WTP of EUR 50,000 per QALY gained. Conclusion: The current intervention was not cost-effective compared to usual care to prevent or postpone new disabilities over a one-year period. Based on these findings, implementation of the evaluated multifactorial nurse-led care model is not to be recommended.

Suggested Citation

  • Jacqueline J Suijker & Janet L MacNeil-Vroomen & Marjon van Rijn & Bianca M Buurman & Sophia E de Rooij & Eric P Moll van Charante & Judith E Bosmans, 2017. "Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-16, April.
    • Handle: RePEc:plo:pone00:0175272
    DOI: 10.1371/journal.pone.0175272
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0175272
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0175272&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0175272?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Réjean Hébert & Michel Raîche & Marie-France Dubois & N'Deye R. Gueye & Nicole Dubuc & Michel Tousignant, 2009. "Impact of PRISMA, a Coordination-Type Integrated Service Delivery System for Frail Older People in Quebec (Canada): A Quasi-experimental Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 65(1), pages 107-118.
    2. Rita Faria & Manuel Gomes & David Epstein & Ian White, 2014. "A Guide to Handling Missing Data in Cost-Effectiveness Analysis Conducted Within Randomised Controlled Trials," PharmacoEconomics, Springer, vol. 32(12), pages 1157-1170, December.
    3. Evan Mayo-Wilson & Sean Grant & Jennifer Burton & Amanda Parsons & Kristen Underhill & Paul Montgomery, 2014. "Preventive Home Visits for Mortality, Morbidity, and Institutionalization in Older Adults: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-1, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Yining Xu & Xin Li & Zhihong Sun & Yang Song & Julien S. Baker & Yaodong Gu, 2021. "Adjusted Indirect and Mixed Comparisons of Interventions for the Patient-Reported Outcomes Measures (PROMs) of Disabled Adults: A Systematic Review and Network Meta-Analysis," IJERPH, MDPI, vol. 18(5), pages 1-29, March.
    2. Beata Wieczorek-Wójcik & Aleksandra Gaworska-Krzemińska & Piotr Szynkiewicz & Michał Wójcik & Monika Orzechowska & Dorota Kilańska, 2022. "Cost-Effectiveness Analysis of Improving Nurses’ Education Level in the Context of In-Hospital Mortality," IJERPH, MDPI, vol. 19(2), pages 1-15, January.
    3. Hossein Haji Ali Afzali & Jonathan Karnon & Olga Theou & Justin Beilby & Matteo Cesari & Renuka Visvanathan, 2019. "Structuring a conceptual model for cost-effectiveness analysis of frailty interventions," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-13, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Andrea Gabrio & Catrin Plumpton & Sube Banerjee & Baptiste Leurent, 2022. "Linear mixed models to handle missing at random data in trial‐based economic evaluations," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1276-1287, June.
    2. Abualbishr Alshreef & Allan J. Wailoo & Steven R. Brown & James P. Tiernan & Angus J. M. Watson & Katie Biggs & Mike Bradburn & Daniel Hind, 2017. "Cost-Effectiveness of Haemorrhoidal Artery Ligation versus Rubber Band Ligation for the Treatment of Grade II–III Haemorrhoids: Analysis Using Evidence from the HubBLe Trial," PharmacoEconomics - Open, Springer, vol. 1(3), pages 175-184, September.
    3. Sun Sun & Nan Luo & Erik Stenberg & Lars Lindholm & Klas-Göran Sahlén & Karl A. Franklin & Yang Cao, 2022. "Sequential Multiple Imputation for Real-World Health-Related Quality of Life Missing Data after Bariatric Surgery," IJERPH, MDPI, vol. 19(17), pages 1-16, August.
    4. Janet MacNeil Vroomen & Iris Eekhout & Marcel G. Dijkgraaf & Hein van Hout & Sophia E. de Rooij & Martijn W. Heymans & Judith E. Bosmans, 2016. "Multiple imputation strategies for zero-inflated cost data in economic evaluations: which method works best?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(8), pages 939-950, November.
    5. Laura Pirhonen & Kristian Bolin & Elisabeth Hansson Olofsson & Andreas Fors & Inger Ekman & Karl Swedberg & Hanna Gyllensten, 2019. "Person-Centred Care in Patients with Acute Coronary Syndrome: Cost-Effectiveness Analysis Alongside a Randomised Controlled Trial," PharmacoEconomics - Open, Springer, vol. 3(4), pages 495-504, December.
    6. Janet MacNeil Vroomen & Judith E Bosmans & Iris Eekhout & Karlijn J Joling & Lisa D van Mierlo & Franka J M Meiland & Hein P J van Hout & Sophia E de Rooij, 2016. "The Cost-Effectiveness of Two Forms of Case Management Compared to a Control Group for Persons with Dementia and Their Informal Caregivers from a Societal Perspective," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-20, September.
    7. Baptiste Leurent & Manuel Gomes & James R. Carpenter, 2018. "Missing data in trial‐based cost‐effectiveness analysis: An incomplete journey," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 1024-1040, June.
    8. William Hollingworth & Christopher G. Fawsitt & Padraig Dixon & Larisa Duffy & Ricardo Araya & Tim J. Peters & Howard Thom & Nicky J. Welton & Nicola Wiles & Glyn Lewis, 2020. "Cost-Effectiveness of Sertraline in Primary Care According to Initial Severity and Duration of Depressive Symptoms: Findings from the PANDA RCT," PharmacoEconomics - Open, Springer, vol. 4(3), pages 427-438, September.
    9. Deidda, Manuela & Geue, Claudia & Kreif, Noemi & Dundas, Ruth & McIntosh, Emma, 2019. "A framework for conducting economic evaluations alongside natural experiments," Social Science & Medicine, Elsevier, vol. 220(C), pages 353-361.
    10. Ângela Jornada Ben & Johanna M. Dongen & Mohamed El Alili & Martijn W. Heymans & Jos W. R. Twisk & Janet L. MacNeil-Vroomen & Maartje Wit & Susan E. M. Dijk & Teddy Oosterhuis & Judith E. Bosmans, 2023. "The handling of missing data in trial-based economic evaluations: should data be multiply imputed prior to longitudinal linear mixed-model analyses?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(6), pages 951-965, August.
    11. Victoria K. Brennan & Georgina Jones & Stephen Radley & Simon Dixon, 2021. "Incorporating Process Utility into Cost-Effectiveness Analysis via a Bolt-On Domain to the SF-6D: An Exploratory Study," Applied Health Economics and Health Policy, Springer, vol. 19(5), pages 747-756, September.
    12. Helen A. Dakin & José Leal & Andrew Briggs & Philip Clarke & Rury R. Holman & Alastair Gray, 2020. "Accurately Reflecting Uncertainty When Using Patient-Level Simulation Models to Extrapolate Clinical Trial Data," Medical Decision Making, , vol. 40(4), pages 460-473, May.
    13. Becky Pennington & Abualbishr Alshreef & Laura Flight & Andrew Metry & Edith Poku & Philip Hykin & Sobha Sivaprasad & A. Toby Prevost & Joana C. Vasconcelos & Caroline Murphy & Joanna Kelly & Yit Yang, 2021. "Cost Effectiveness of Ranibizumab vs Aflibercept vs Bevacizumab for the Treatment of Macular Oedema Due to Central Retinal Vein Occlusion: The LEAVO Study," PharmacoEconomics, Springer, vol. 39(8), pages 913-927, August.
    14. Alexina J. Mason & Manuel Gomes & James Carpenter & Richard Grieve, 2021. "Flexible Bayesian longitudinal models for cost‐effectiveness analyses with informative missing data," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 3138-3158, December.
    15. Padraig Dixon & William Hollingworth & Jonathan Benger & James Calvert & Melanie Chalder & Anna King & Stephanie MacNeill & Katherine Morton & Emily Sanderson & Sarah Purdy, 2020. "Observational Cost-Effectiveness Analysis Using Routine Data: Admission and Discharge Care Bundles for Patients with Chronic Obstructive Pulmonary Disease," PharmacoEconomics - Open, Springer, vol. 4(4), pages 657-667, December.
    16. Baptiste Leurent & Manuel Gomes & Rita Faria & Stephen Morris & Richard Grieve & James R. Carpenter, 2018. "Sensitivity Analysis for Not-at-Random Missing Data in Trial-Based Cost-Effectiveness Analysis: A Tutorial," PharmacoEconomics, Springer, vol. 36(8), pages 889-901, August.
    17. Andrea Gabrio & Alexina J. Mason & Gianluca Baio, 2017. "Handling Missing Data in Within-Trial Cost-Effectiveness Analysis: A Review with Future Recommendations," PharmacoEconomics - Open, Springer, vol. 1(2), pages 79-97, June.
    18. Mohamed El Alili & Johanna M. van Dongen & Jonas L. Esser & Martijn W. Heymans & Maurits W. van Tulder & Judith E. Bosmans, 2022. "A scoping review of statistical methods for trial‐based economic evaluations: The current state of play," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2680-2699, December.
    19. Anna I I King & Michal L Boyd & Lynelle Dagley & Deborah L Raphael, 2018. "Implementation of a gerontology nurse specialist role in primary health care: Health professional and older adult perspectives," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(3-4), pages 807-818, February.
    20. Bernhard Michalowsky & Wolfgang Hoffmann & Kevin Kennedy & Feng Xie, 2020. "Is the whole larger than the sum of its parts? Impact of missing data imputation in economic evaluation conducted alongside randomized controlled trials," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(5), pages 717-728, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0175272. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.