Abstract
Objectives To enhance adherence to cardiac rehabilitation (CR), a patient education programme called a € learning and coping' (LC-programme) was implemented in three hospitals in Denmark. The aim of this study was to investigate the cost-utility of the LC-programme compared with the standard CR-programme. Methods 825 patients with ischaemic heart disease or heart failure were randomised to the LC-programme or the standard CR-programme and were followed for 3 years. A societal cost perspective was applied and quality-adjusted life years (QALY) were based on SF-6D measurements. Multiple imputation technique was used to handle missing data on the SF-6D. The statistical analyses were based on means and bootstrapped SEs. Regression framework was employed to estimate the net benefit and to illustrate cost-effectiveness acceptability curves. Results No statistically significant differences were found between the two programmes in total societal costs (4353 Euros; 95% CI -3828 to 12 533) or in QALY (-0.006; 95% CI -0.053 to 0.042). At a threshold of 40 000 Euros, the LC-programme was found to be cost-effective at 15% probability; however, for patients with heart failure, due to increased cost savings, the probability of cost-effectiveness increased to 91%. Conclusions While the LC-programme did not appear to be cost-effective in CR, important heterogeneity was noted for subgroups of patients. The LC-programme was demonstrated to increase adherence to the rehabilitation programme and to be cost-effective among patients with heart failure. However, further research is needed to study the dynamic value of heterogeneity due to the small sample size in this subgroup.
Original language | English |
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Article number | e001184 |
Journal | Open Heart |
Volume | 7 |
Issue number | 1 |
ISSN | 2398-595X |
DOIs | |
Publication status | Published - 8 Jan 2020 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords
- cardiac rehabilitation
- education
- heart failure