دورية أكاديمية
أعرض في EDS

An Electronic Patient-Reported Outcomes Tool for Older Adults With Complex Chronic Conditions: Cost-Utility Analysis.

التفاصيل البيبلوغرافية
العنوان: An Electronic Patient-Reported Outcomes Tool for Older Adults With Complex Chronic Conditions: Cost-Utility Analysis.
المؤلفون: Miranda RN; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON, Canada., Bhuiya AR; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Thraya Z; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Hancock-Howard R; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Chan BC; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada., Steele Gray C; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada., Wodchis WP; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada., Thavorn K; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
المصدر: JMIR aging [JMIR Aging] 2022 Apr 20; Vol. 5 (2), pp. e35075. Date of Electronic Publication: 2022 Apr 20.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: JMIR Publications Inc Country of Publication: Canada NLM ID: 101740387 Publication Model: Electronic Cited Medium: Internet ISSN: 2561-7605 (Electronic) Linking ISSN: 25617605 NLM ISO Abbreviation: JMIR Aging Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Toronto, ON] : JMIR Publications Inc., [2018]-
مستخلص: Background: eHealth technologies for self-management can improve quality of life, but little is known about whether the benefits gained outweigh their costs. The electronic patient-reported outcome (ePRO) mobile app and portal system supports patients with multiple chronic conditions to collaborate with primary health care providers to set and monitor health-related goals.
Objective: This study aims to estimate the cost of ePRO and the cost utility of the ePRO intervention compared with usual care provided to patients with multiple chronic conditions and complex needs living in the community, from the perspective of the publicly funded health care payer in Ontario, Canada.
Methods: We developed a decision tree model to estimate the incremental cost per quality-adjusted life year (QALY) gained for the ePRO tool versus usual care over a time horizon of 15 months. Resource utilization and effectiveness of the ePRO tool were drawn from a randomized clinical trial with 6 family health teams involving 45 participants. Unit costs associated with health care utilization (adjusted to 2020 Canadian dollars) were drawn from literature and publicly available sources. A series of sensitivity analyses were conducted to assess the robustness of the findings.
Results: The total cost of the ePRO tool was CAD $79,467 (~US $ 63,581; CAD $1733 [~US $1386] per person). Compared with standard care, the ePRO intervention was associated with higher costs (CAD $1710 [~US $1368]) and fewer QALYs (-0.03). The findings were consistent with the clinical evidence, suggesting no statistical difference in health-related quality of life between ePRO and usual care groups. However, the tool would be considered a cost-effective option if it could improve by at least 0.03 QALYs. The probability that the ePRO is cost-effective was 17.3% at a willingness-to-pay (WTP) threshold of CAD $50,000 (~US $40,000)/QALY.
Conclusions: The ePRO tool is not a cost-effective technology at the commonly used WTP value of CAD $50,000 (~US $40,000)/QALY, but long-term and the societal impacts of ePRO were not included in this analysis. Further research is needed to better understand its impact on long-term outcomes and in real-world settings. The present findings add to the growing evidence about eHealth interventions' capacity to respond to complex aging populations within finite-resourced health systems.
Trial Registration: ClinicalTrials.gov NCT02917954; https://clinicaltrials.gov/ct2/show/NCT02917954.
(©Rafael N Miranda, Aunima R Bhuiya, Zak Thraya, Rebecca Hancock-Howard, Brian CF Chan, Carolyn Steele Gray, Walter P Wodchis, Kednapa Thavorn. Originally published in JMIR Aging (https://aging.jmir.org), 20.04.2022.)
References: JMIR Res Protoc. 2014 Nov 26;3(4):e67. (PMID: 25428028)
Health Econ. 2006 Jul;15(7):677-87. (PMID: 16491461)
PLoS One. 2017 Feb 2;12(2):e0170581. (PMID: 28152012)
J Gen Intern Med. 2018 Dec;33(12):2106-2112. (PMID: 30291604)
BMC Public Health. 2014 Jan 15;14:38. (PMID: 24428802)
Health Econ. 2005 May;14(5):487-96. (PMID: 15497198)
Int J Environ Res Public Health. 2020 Jun 14;17(12):. (PMID: 32545876)
JMIR Form Res. 2019 Feb 27;3(1):e11950. (PMID: 30810532)
Health Aff (Millwood). 2015 Mar;34(3):431-7. (PMID: 25732493)
J Comorb. 2012 Oct 10;2:1-9. (PMID: 29090137)
J Med Internet Res. 2021 Dec 2;23(12):e29071. (PMID: 34860675)
J Comorb. 2016 Feb 17;6(1):4-11. (PMID: 29090166)
Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26. (PMID: 15230939)
JAMA Ophthalmol. 2017 May 1;135(5):452-459. (PMID: 28358948)
JAMA. 2010 Jun 2;303(21):2186-7. (PMID: 20516421)
CMAJ. 2016 Feb 16;188(3):182-188. (PMID: 26755672)
BMC Fam Pract. 2013 Sep 08;14:133. (PMID: 24010523)
Prim Health Care Res Dev. 2018 Mar;19(2):151-164. (PMID: 28899449)
JMIR Res Protoc. 2016 Jun 24;5(2):e126. (PMID: 27341765)
J Clin Epidemiol. 2003 Feb;56(2):138-47. (PMID: 12654408)
BMJ. 2012 Mar 23;344:e1756. (PMID: 22446569)
Chronic Illn. 2007 Jun;3(2):167-75. (PMID: 18083671)
BMJ Qual Saf. 2018 Dec;27(12):989-999. (PMID: 30139822)
BMC Health Serv Res. 2019 May 16;19(1):313. (PMID: 31096989)
Eval Health Prof. 2010 Sep;33(3):343-64. (PMID: 20801976)
Qual Life Res. 2005 Aug;14(6):1489-500. (PMID: 16110929)
BMJ Open. 2017 Oct 6;7(10):e017264. (PMID: 28988178)
Health Aff (Millwood). 2014 Feb;33(2):265-72. (PMID: 24493770)
JMIR Mhealth Uhealth. 2016 Jun 02;4(2):e58. (PMID: 27256035)
JMIR Res Protoc. 2016 Feb 18;5(1):e28. (PMID: 26892952)
J Med Internet Res. 2014 Sep 22;16(9):e213. (PMID: 25245774)
Eur J Prev Cardiol. 2015 Jun;22(6):701-9. (PMID: 24817694)
J Telemed Telecare. 2014 Dec;20(8):431-5. (PMID: 25316037)
N Engl J Med. 2012 Mar 1;366(9):777-9. (PMID: 22375966)
فهرسة مساهمة: Keywords: Canada; North America; aging; chronic condition; chronic disease; community; complex care; cost; cost-effectiveness; decision tree; eHealth; elder; model; multimorbidity; older adult; patient reported outcome; primary care; sensitivity analysis
سلسلة جزيئية: ClinicalTrials.gov NCT02917954
تواريخ الأحداث: Date Created: 20220420 Latest Revision: 20220716
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC9069297
DOI: 10.2196/35075
PMID: 35442194
قاعدة البيانات: MEDLINE
الوصف
تدمد:2561-7605
DOI:10.2196/35075