دورية أكاديمية
A cost-effectiveness analysis of early detection and bundled treatment of postpartum hemorrhage alongside the E-MOTIVE trial.
| العنوان: | A cost-effectiveness analysis of early detection and bundled treatment of postpartum hemorrhage alongside the E-MOTIVE trial. |
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| المؤلفون: | Williams EV; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Goranitis I; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia., Oppong R; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Perry SJ; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Devall AJ; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Martin JT; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Mammoliti KM; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Beeson LE; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Sindhu KN; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Galadanci H; African Center of Excellence for Population Health and Policy, College of Health Sciences, Bayero University, Kano, Nigeria., Alwy Al-Beity F; Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Qureshi Z; Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya., Hofmeyr GJ; Effective Care Research Unit, University of the Witwatersrand, Johannesburg, South Africa.; Department of Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana., Moran N; KwaZulu-Natal Department of Health, Pietermaritzburg, South Africa., Fawcus S; Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa., Mandondo S; Eastern Cape Department of Health, Bhisho, South Africa.; Department of Obstetrics and Gynaecology, Walter Sisulu University, Mthatha, South Africa., Middleton L; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Hemming K; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Oladapo OT; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland., Gallos ID; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland., Coomarasamy A; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Roberts TE; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. t.e.roberts@bham.ac.uk. |
| المصدر: | Nature medicine [Nat Med] 2024 Jun 06. Date of Electronic Publication: 2024 Jun 06. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Nature Publishing Company Country of Publication: United States NLM ID: 9502015 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1546-170X (Electronic) Linking ISSN: 10788956 NLM ISO Abbreviation: Nat Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York Ny : Nature Publishing Company Original Publication: New York, NY : Nature Pub. Co., [1995- |
| مستخلص: | Timely detection and treatment of postpartum hemorrhage (PPH) are crucial to prevent complications or death. A calibrated blood-collection drape can help provide objective, accurate and early diagnosis of PPH, and a treatment bundle can address delays or inconsistencies in the use of effective interventions. Here we conducted an economic evaluation alongside the E-MOTIVE trial, an international, parallel cluster-randomized trial with a baseline control phase involving 210,132 women undergoing vaginal delivery across 78 secondary-level hospitals in Kenya, Nigeria, South Africa and Tanzania. We aimed to assess the cost-effectiveness of the E-MOTIVE intervention, which included a calibrated blood-collection drape for early detection of PPH and a bundle of first-response treatments (uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, examination and escalation), compared with usual care. We used multilevel modeling to estimate incremental cost-effectiveness ratios from the perspective of the public healthcare system for outcomes of cost per severe PPH (blood loss ≥1,000 ml) avoided and cost per disability-adjusted life-year averted. Our findings suggest that the use of a calibrated blood-collection drape for early detection of PPH and bundled first-response treatment is cost-effective and should be perceived by decision-makers as a worthwhile use of healthcare budgets. ClinicalTrials.gov identifier: NCT04341662 . (© 2024. The Author(s).) |
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| معلومات مُعتمدة: | 001 International WHO_ World Health Organization; INV-001393 United States GATES Bill & Melinda Gates Foundation |
| سلسلة جزيئية: | ClinicalTrials.gov NCT04341662 |
| تواريخ الأحداث: | Date Created: 20240606 Latest Revision: 20240720 |
| رمز التحديث: | 20240720 |
| DOI: | 10.1038/s41591-024-03069-5 |
| PMID: | 38844798 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1546-170X |
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| DOI: | 10.1038/s41591-024-03069-5 |