Angus, C. orcid.org/0000-0003-0529-4135, Li, J., Romero-Rodriguez, E. et al. (3 more authors) (2018) Cost-effectiveness of strategies to improve delivery of brief interventions for heavy drinking in primary care: results from the ODHIN trial. European Journal of Public Health. ISSN 1101-1262
Abstract
Background: Screening and brief interventions (SBIs) for heavy drinking are an effective and cost-effective approach to reducing alcohol-related harm, yet delivery rates remain low. This study uses trial data to estimate the cost-effectiveness of alternative strategies to increase SBI delivery. Methods: Data from a large cluster-randomized trial were combined with the Sheffield Alcohol Policy Model, a policy appraisal tool, to estimate the cost-effectiveness of eight strategies to increase SBI delivery in primary care in England, Poland and the Netherlands: care as usual (control), training and support (TS), financial reimbursement (FR), referral of patients to an online brief intervention (eBI) and all combinations of TS, FR and eBI. cost-effectiveness was assessed from a healthcare perspective by comparing health benefits (measured in Quality-Adjusted Life Years) with total implementation costs and downstream healthcare savings for each strategy over a 30-year horizon and calculating Incremental cost-effectiveness ratios (ICERs). Results: All trialled strategies were cost-effective compared to control. TS combined with FR was the most cost-effective approach in England (more effective and less costly than control) and Poland (ICER €4632 vs. next-best strategy). This combination is not cost-effective in the Netherlands, where TS alone is the most cost-effective approach (ICER €3386 vs. next-best strategy). Conclusions: Structured TS, financial incentives and access to online interventions are all estimated to be cost-effective methods of improving delivery of alcohol brief interventions. TS and FR together may be the most cost-effective approach, however this is sensitive to country characteristics and alternative BI effect assumptions. Trial registration: ClinicalTrials.gov trial identifier: NCT01501552.
Metadata
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Copyright, Publisher and Additional Information: | © 2018 The Author(s). This is an author produced version of a paper subsequently published in European Journal of Public Health. Uploaded in accordance with the publisher's self-archiving policy. | ||||
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Institution: | The University of Sheffield | ||||
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research | ||||
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Depositing User: | Symplectic Sheffield | ||||
Date Deposited: | 09 Oct 2018 15:18 | ||||
Last Modified: | 17 Mar 2019 01:39 | ||||
Published Version: | https://doi.org/10.1093/eurpub/cky181 | ||||
Status: | Published online | ||||
Publisher: | Oxford University Press | ||||
Refereed: | Yes | ||||
Identification Number: | https://doi.org/10.1093/eurpub/cky181 | ||||
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