دورية أكاديمية
أعرض في EDS

Economic evaluation alongside a clinical trial of near-to-patient testing for sexually transmitted infections.

التفاصيل البيبلوغرافية
العنوان: Economic evaluation alongside a clinical trial of near-to-patient testing for sexually transmitted infections.
المؤلفون: Zhang Y; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia., Vodstrcil LA; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia., Htaik K; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia., Plummer EL; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia., De Petra V; Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity at The University of Melbourne, Melbourne, Victoria, Australia., Sen MG; Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity at The University of Melbourne, Melbourne, Victoria, Australia., Williamson DA; Department of Infectious Diseases, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Victorian Infectious Diseases Reference Laboratory, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia., Owlad M; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia., Murray G; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia., Chow EP; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia., Fairley CK; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia., Bradshaw CS; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia., Ong JJ; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Electronic address: Jason.ong@monash.edu.
المصدر: Journal of infection and public health [J Infect Public Health] 2024 Jul; Vol. 17 (7), pp. 102447. Date of Electronic Publication: 2024 May 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 101487384 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-035X (Electronic) Linking ISSN: 18760341 NLM ISO Abbreviation: J Infect Public Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford : Elsevier, 2008-
مواضيع طبية MeSH: Sexually Transmitted Diseases*/diagnosis , Sexually Transmitted Diseases*/economics , Sexually Transmitted Diseases*/drug therapy, Humans ; Male ; Female ; Gonorrhea/diagnosis ; Gonorrhea/economics ; Gonorrhea/drug therapy ; Australia ; Adult ; Cost-Benefit Analysis ; Chlamydia Infections/diagnosis ; Chlamydia Infections/economics ; Chlamydia Infections/drug therapy ; Chlamydia trachomatis ; Neisseria gonorrhoeae/isolation & purification ; Mycoplasma genitalium ; Mass Screening/economics ; Mass Screening/methods ; Mycoplasma Infections/diagnosis ; Mycoplasma Infections/drug therapy ; Mycoplasma Infections/economics ; Urethritis/diagnosis ; Urethritis/economics ; Urethritis/drug therapy ; Urethritis/microbiology
مستخلص: Background: Current clinical care for common bacterial STIs (Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma genitalium (MG)) involves empiric antimicrobial therapy when clients are symptomatic, or if asymptomatic, waiting for laboratory testing and recall if indicated. Near-to-patient testing (NPT) can improve pathogen-specific prescribing and reduce unnecessary or inappropriate antibiotic use in treating sexually transmitted infections (STI) by providing same-day delivery of results and treatment.
Methods: We compared the economic cost of NPT to current clinic practice for managing clients with suspected proctitis, non-gonococcal urethritis (NGU), or as an STI contact, from a health provider's perspective. With a microsimulation of 1000 clients, we calculated the cost per client tested and per STI- and pathogen- detected for each testing strategy. Sensitivity analyses were conducted to assess the robustness of the main outcomes. Costs are reported as Australian dollars (2023).
Results: In the standard care arm, cost per client tested for proctitis, NGU in men who have sex with men (MSM) and heterosexual men were the highest at $247.96 (95% Prediction Interval (PI): 246.77-249.15), $204.23 (95% PI: 202.70-205.75) and $195.01 (95% PI: 193.81-196.21) respectively. Comparatively, in the NPT arm, it costs $162.36 (95% PI: 161.43-163.28), $158.39 (95% PI: 157.62-159.15) and $149.17 (95% PI: 148.62-149.73), respectively. Using NPT resulted in cost savings of 34.52%, 22.45% and 23.51%, respectively. Among all the testing strategies, substantial difference in cost per client tested between the standard care arm and the NPT arm was observed for contacts of CT or NG, varying from 27.37% to 35.28%.
Conclusion: We found that NPT is cost-saving compared with standard clinical care for individuals with STI symptoms and sexual contacts of CT, NG, and MG.
Competing Interests: Declaration of Competing Interest CSB and CKF were supported by an Australian National Health and Medical Research Council Leadership Investigator Grant (GNT1173361 and GNT1172900, respectively). JJO and EPFC are supported by an Australian National Health and Medical Research Council Emerging Leadership Investigator Grant (GNT1193955 and GNT1172873). YZ is supported by an Australian Government Research Training Program (RTP) scholarship. All other authors declare no competing interests.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
فهرسة مساهمة: Keywords: Chlamydia trachomatis; Cost-effectiveness; Economic evaluation; Neisseria gonorrhoeae, Mycoplasma genitalium; Sexually transmitted infections
تواريخ الأحداث: Date Created: 20240602 Date Completed: 20240620 Latest Revision: 20240620
رمز التحديث: 20240621
DOI: 10.1016/j.jiph.2024.05.004
PMID: 38824739
قاعدة البيانات: MEDLINE
الوصف
تدمد:1876-035X
DOI:10.1016/j.jiph.2024.05.004