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Assessing the cost-effectiveness of RT Prepare: A radiation therapist-delivered intervention for reducing psychological distress prior to radiotherapy.

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  • معلومة اضافية
    • Corporate Authors:
      RT Prepare project team
    • المصدر:
      Publisher: Wiley Country of Publication: England NLM ID: 9214524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1099-1611 (Electronic) Linking ISSN: 10579249 NLM ISO Abbreviation: Psychooncology Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Chichester, W. Sussex, England : Wiley, c1992-
    • الموضوع:
      Psychological Distress* ; Quality of Life*; Allied Health Personnel/*education ; Anxiety/*therapy ; Breast Neoplasms/*psychology ; Depression/*therapy ; Patient Education as Topic/*methods; Anxiety/psychology ; Australia ; Breast Neoplasms/radiotherapy ; Cost-Benefit Analysis ; Depression/psychology ; Female ; Health Services/statistics & numerical data ; Humans ; Middle Aged ; Minimal Clinically Important Difference ; Social Support
    • نبذة مختصرة :
      Objective: To determine the cost-effectiveness of RT Prepare in reducing breast cancer patients' psychological distress before treatment, compared with usual care.
      Methods: RT Prepare, an intervention involving patient education and support consultations with a radiation therapist (RT), was implemented at three Australian sites (Australian New Zealand Clinical Trials Registration: ACTRN12611001000998). The primary outcome was change in psychological distress using the Hospital Anxiety and Depression Scale (HADS); secondary outcomes were changes in quality of life (QoL) and additional health service use. Costs (2015 $AU) included consultation time and training delivery. Between-group comparisons of HADS and QoL used generalised linear mixed models, and comparisons of health service use used negative binomial regression. Incremental cost-effectiveness ratios (ICERs) indicated mean costs per 1-point decrease in HADS score. Sensitivity analyses explored variation in facility size and uncertainty in intervention effectiveness.
      Results: Among 218 controls and 189 intervention participants, the intervention significantly lowered HADS scores at treatment commencement (adjusted mean difference 1.06 points). There was no significant effect on QoL or additional service use. Mean intervention costs were AU$171 per participant (US$130, €119) mostly related to RT training (approximately AU$142 (US$108, €99). An ICER of $158 (US$120, €110) was estimated. Cost-effectiveness improved in a sensitivity analysis representing a large facility with higher patient numbers.
      Conclusion: This study provides new data on the cost-effectiveness of an RT-delivered intervention to reduce psychological distress prior to treatment, which will be useful to inform delivery of similar services. As most costs were upfront, cost-effectiveness would likely improve if implemented as standard care.
      (© 2019 John Wiley & Sons, Ltd.)
    • Contributed Indexing:
      Keywords: anxiety; breast cancer; cost-effectiveness; distress; radiation therapy
    • Molecular Sequence:
      ANZCTR ACTRN12611001000998
    • الموضوع:
      Date Created: 20190319 Date Completed: 20200327 Latest Revision: 20200327
    • الموضوع:
      20240628
    • الرقم المعرف:
      10.1002/pon.5065
    • الرقم المعرف:
      30884030