Latimer, N.R. orcid.org/0000-0001-5304-5585, Bhadhuri, A., Alshreef, A.O. et al. (10 more authors) (2021) Self-managed, computerised word finding therapy as an add-on to usual care for chronic aphasia post-stroke : an economic evaluation. Clinical Rehabilitation, 35 (5). pp. 703-717. ISSN 0269-2155
Abstract
Objective:
To examine the cost-effectiveness of self-managed computerised word finding therapy as an add-on to usual care for people with aphasia post-stroke.
Design:
Cost-effectiveness modelling over a life-time period, taking a UK National Health Service (NHS) and personal social service perspective.
Setting:
Based on the Big CACTUS randomised controlled trial, conducted in 21 UK NHS speech and language therapy departments.
Participants:
Big CACTUS included 278 people with long-standing aphasia post-stroke.
Interventions:
Computerised word finding therapy plus usual care; usual care alone; usual care plus attention control.
Main measures:
Incremental cost-effectiveness ratios (ICER) were calculated, comparing the cost per quality adjusted life year (QALY) gained for each intervention. Credible intervals (CrI) for costs and QALYs, and probabilities of cost-effectiveness, were obtained using probabilistic sensitivity analysis. Subgroup and scenario analyses investigated cost-effectiveness in different subsets of the population, and the sensitivity of results to key model inputs.
Results:
Adding computerised word finding therapy to usual care had an ICER of £42,686 per QALY gained compared with usual care alone (incremental QALY gain: 0.02 per patient (95% CrI: −0.05 to 0.10); incremental costs: £732.73 per patient (95% CrI: £674.23 to £798.05)). ICERs for subgroups with mild or moderate word finding difficulties were £22,371 and £21,262 per QALY gained respectively.
Conclusion:
Computerised word finding therapy represents a low cost add-on to usual care, but QALY gains and estimates of cost-effectiveness are uncertain. Computerised therapy is more likely to be cost-effective for people with mild or moderate, as opposed to severe, word finding difficulties.
Metadata
Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page. | ||||
Keywords: | Aphasia; speech therapy; cost-effectiveness; computer supported; self-management | ||||
Dates: |
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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) > Sheffield Centre for Health and Related Research The University of Sheffield > Sheffield Teaching Hospitals |
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Funding Information: |
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Depositing User: | Symplectic Sheffield | ||||
Date Deposited: | 27 Nov 2020 09:32 | ||||
Last Modified: | 02 Feb 2022 09:00 | ||||
Status: | Published | ||||
Publisher: | SAGE Publications | ||||
Refereed: | Yes | ||||
Identification Number: | https://doi.org/10.1177/0269215520975348 | ||||
Related URLs: |
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