White Rose University Consortium logo
University of Leeds logo University of Sheffield logo York University logo

The effectiveness and cost effectiveness of a national lay led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial

Kennedy, A., Reeves, D., Bower, P., Lee, V., Middleton, E., Richardson, G., Gardner, C., Gately, C. and Rogers, A. (2007) The effectiveness and cost effectiveness of a national lay led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial. Journal of Epidemiology and Community Health, 61 (3). pp. 254-261. ISSN 0143-005X

Full text not available from this repository.

Abstract

Objective: Supporting patients’ self care could have a major effect on the management of long-term conditions, which has led to worldwide interest in effective self care interventions. In England, self care support is being developed through the "Expert Patients Programme", which provides lay-led generic courses to improve patients’ self care skills. However, the clinical and cost effectiveness of such courses remains unclear.

Methods: Two-arm pragmatic randomised controlled trial design with waiting list control in community settings in England. 629 patients with a wide range of self-defined long-term conditions were studied. The lay-led self care support group involved 6-weekly sessions to teach self care skills. Primary outcomes were self-efficacy, reported energy and routine health services utilisation at 6 months. A cost-effectiveness analysis was also conducted.

Results: Patients receiving immediate course access reported considerably greater self-efficacy and energy at 6-month follow-up, but reported no statistically significant reductions in routine health services utilisation over the same time period. The cost-effectiveness analysis showed that patients receiving immediate course access reported considerably greater health related quality of life, and a small reduction in costs. If a quality adjusted life year was valued at £20 000 ($39 191; {euro}30 282), there was a 70% probability that the intervention was cost effective.

Conclusions: Lay-led self care support groups are effective in improving self-efficacy and energy levels among patients with long-term conditions, and are likely to be cost effective over 6 months at conventional values of a decision-maker’s willingness to pay. They may be a useful addition to current services in the management of long-term conditions.

Abbreviations: CDSMP, chronic disease self management programme; EPP, Expert Patients Programme; NHS, National Health Service; REPORT, Research into Expert Patients—Outcomes in a Randomised Trial; QALY, quality-adjusted life year

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Centre for Health Economics (York)
Depositing User: York RAE Import
Date Deposited: 23 Apr 2009 15:09
Last Modified: 23 Apr 2009 15:09
Published Version: http://dx.doi.org/10.1136/jech.2006.053538
Status: Published
Publisher: BMJ Publishing Group; 1999
Identification Number: 10.1136/jech.2006.053538
URI: http://eprints.whiterose.ac.uk/id/eprint/6634

Actions (repository staff only: login required)