Cost-effectiveness of supported self-management for CFS/ME patients in primary care

Richardson, Gerry and Epstein, David and Chew-Graham, Carolyn and Dowrick, Christopher and Bentall, Richard P. and Morriss, Richard K. and Peters, Sarah and Riste, Lisa and Lovell, Karina and Dunn, Graham and Wearden, Alison J. (2013) Cost-effectiveness of supported self-management for CFS/ME patients in primary care. BMC Family Practice, 14 (Januar). 9/1-9/9. ISSN 1471-2296

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Abstract

Background:

Nurse led self-help treatments for people with chronic fatigue syndrome/myalgic encephalitis (CFS/ME) have been shown to be effective in reducing fatigue but their cost-effectiveness is unknown.

Methods:

Cost-effectiveness analysis conducted alongside a single blind randomised controlled trial comparing pragmatic rehabilitation (PR) and supportive listening (SL) delivered by primary care nurses, and treatment as usual (TAU) delivered by the general practitioner (GP) in North West England. A within trial analysis was conducted comparing the costs and quality adjusted life years (QALYs) measured within the time frame of the trial. 296 patients aged 18 and over with CFS/ME diagnosed using the Oxford criteria were included in the cost-effectiveness analysis.

Results:

Treatment as usual is less expensive and leads to better patient outcomes compared with Supportive Listening. Treatment as usual is also less expensive than Pragmatic Rehabilitation. PR was effective at reducing fatigue in the short term, but the impact of the intervention on QALYs was uncertain. However, based on the results of this trial, PR is unlikely to be cost-effective in this patient population.

Conclusions:

This analysis does not support the introduction of SL. Any benefits generated by PR are unlikely to be of sufficient magnitude to warrant recommending PR for this patient group on cost-effectiveness grounds alone. However, dissatisfaction with current treatment options means simply continuing with ‘treatment as usual’ in primary care is unlikely to be acceptable to patients and practitioners.

Item Type: Article
Keywords: Cost-effectiveness, Primary care, CFS/ME, Self-management, Supportive listening, Pragmatic rehabilitation
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: https://doi.org/10.1186/1471-2296-14-12
Depositing User: Davies, Mrs Sarah
Date Deposited: 08 Apr 2014 09:38
Last Modified: 15 Sep 2016 16:30
URI: http://eprints.nottingham.ac.uk/id/eprint/2634

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