Cost-Effectiveness of a 24 Month INTERdisciplinary COMmunity-Based COPD Management Program (INTERCOM) in Patients with Less Advanced Airflow Obstruction.

Wetering, CR van; Hoogendoorn, Martine; Munck, de; Mölken, MP Rutten-van; Schols, AM

doi:10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a5373

Cited by 6 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the combined results of the clinical analyses published elsewhere [13][14][15] and the cost-effectiveness analyses presented here, we conclude that compared to usual care, the INTERCOM programme resulted in significant improvements in SGRQ total score and several exercise performance and dyspnoea measures at a cost increase of J2,751 per patient. In terms of costs per QALY, the programme is moderately costeffective.…”

Section: Discussionmentioning

confidence: 60%

“…This CEA was performed alongside a 2-yr randomised controlled trial evaluating the effect of an INTERdisciplinary COMmunity-based COPD management programme (INTERCOM) compared with usual care. Full clinical results of this trial have been reported elsewhere [13][14][15]. In brief, results over the total 2-yr period showed that there were significantly better effects in the INTERCOM group than for usual care in St George's Respiratory Questionnaire (SGRQ) total score, Medical Research Council dysnoea score, 6-min walk distance (6MWD) and cycle endurance time in a constant work rate test at 70% of peak exercise capacity.…”

mentioning

confidence: 94%

See 1 more Smart Citation

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Hoogendoorn¹,

Wetering²,

Schols³

et al. 2009

European Respiratory Journal

View full text Add to dashboard Cite

The study aimed to estimate the cost-effectiveness of interdisciplinary communitybased chronic obstructive pulmonary disease (COPD) management in patients with COPD.We conducted a cost-effectiveness analysis alongside a 2-yr randomised controlled trial, in which 199 patients with less advanced airflow obstruction and impaired exercise capacity were assigned to the INTERCOM programme or usual care. The INTERCOM programme consisted of exercise training, education, nutritional therapy and smoking cessation counselling offered by community-based physiotherapists and dieticians and hospital-based respiratory nurses. Allcause resource use during 2 yrs was obtained by self-report and from hospital and pharmacy records. Health outcomes were the St George's Respiratory Questionnaire (SGRQ), exacerbations and quality-adjusted life years (QALYs).The INTERCOM group had 30% (95% CI 3-56%) more patients with a clinically relevant improvement in SGRQ total score, 0.08 (95% CI -0.01-0.18) more QALYs per patient, but a higher mean number of exacerbations, 0.84 (95% CI -0.07-1.78). Mean total 2-yr costs were J2,751 (95% CI -J632-J6,372) higher for INTERCOM than for usual care, which resulted in an incremental cost-effectiveness ratio of J9,078 per additional patient with a relevant improvement in SGRQ or J32,425 per QALY.INTERCOM significantly improved disease-specific quality of life, but did not affect exacerbation rate. The cost per QALY ratio was moderate, but within the range of that generally considered to be acceptable.

show abstract

Section: Discussionmentioning

confidence: 60%

mentioning

confidence: 94%

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Hoogendoorn¹,

Wetering²,

Schols³

et al. 2009

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…An exercise training programme in primary care will be a relatively cheap and an easily accessible intervention for more patients than an expensive hospital-based rehabilitation programme [ 28 ]. Although longitudinal studies are lacking, it is suggested that early recognition of progression of exercise impairment especially in less advanced COPD patients is relevant to prevent further deterioration of functional capacity [ 22 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is the possibility to refer patients with mild to moderate COPD to registered physiotherapists, experienced in COPD care. The implementation of this disease management programme for COPD is encouraged by the reimbursement through so-called chained diagnose-treatment combination (DTC) [ 29 ]. Although in some regions in the Netherlands these disease management programmes for COPD are already implemented and serve as current daily care, no evidence on the effectiveness of these programmes is available.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a physical exercise training programme COPD in primary care: study protocol of a randomized controlled trial

et al. 2014

View full text Add to dashboard Cite

BackgroundChronic obstructive pulmonary disease (COPD) is recognized as a systemic illness with significant extra-pulmonary features, such as exercise intolerance and muscle weakness. Pulmonary rehabilitation has been shown to be very effective in counteracting these consequences in patients with more advanced COPD. However, limited data is available on the efficacy of a physical exercise training programme in patients with mild to moderate COPD in primary care. Furthermore, it is unknown if improved exercise capacity translates into enhanced daily physical activities. The aim of this paper is to describe the design of a randomized controlled trial to assess the efficacy of a physical exercise training programme in patients with mild to moderate COPD.Methods/designIn this randomized controlled trial situated in the primary care setting, 102 patients with mild to moderate airflow obstruction (FEV1 ≥ 50% of predicted), dyspnoea and a physically inactive lifestyle will be randomized to an intervention or control group. The intervention group receives a 4-month physical exercise training programme at a local physiotherapy practice, which includes exercise training, resistance training, breathing exercises and advises on how to increase the level of physical activity. The control group receives usual care, i.e. advises on how to increase the level of physical activity and a sham treatment at a local physiotherapy practice of which no physiological training stimulus can be expected. Primary outcome is functional exercise capacity at 4-months measured on the six-minute walk distance. Secondary outcomes include peripheral muscle strength, physical activity in daily life, health related quality of life, Medical Research Council (MRC) dyspnoea score and patients’ perceived effectiveness. Follow-up measurement will take place at 6 months after baseline.DiscussionThis will be one of the first studies to evaluate the efficacy of a physical exercise training programme in patients with mild to moderate COPD completely recruited and assessed in primary care. The results of this trial may give a unique insight into the potential of the implementation of an easy, close-to-home rehabilitation programme.Trial registrationThe Netherlands National Trial Register NTR1471.

show abstract

Pulmonary rehabilitation for chronic obstructive pulmonary disease

McCarthy

Casey

Devane

et al. 2015

Cochrane Database of Systematic Reviews

1,601

1,235

View full text Add to dashboard Cite

Pulmonary rehabilitation relieves dyspnoea and fatigue, improves emotional function and enhances the sense of control that individuals have over their condition. These improvements are moderately large and clinically significant. Rehabilitation serves as an important component of the management of COPD and is beneficial in improving health-related quality of life and exercise capacity. It is our opinion that additional RCTs comparing pulmonary rehabilitation and conventional care in COPD are not warranted. Future research studies should focus on identifying which components of pulmonary rehabilitation are essential, its ideal length and location, the degree of supervision and intensity of training required and how long treatment effects persist. This endeavour is important in the light of the new subgroup analysis, which showed a difference in treatment effect on the CRQ between hospital-based and community-based programmes but no difference between exercise only and more complex pulmonary rehabilitation programmes.

show abstract

Cost-Effectiveness of a 24 Month INTERdisciplinary COMmunity-Based COPD Management Program (INTERCOM) in Patients with Less Advanced Airflow Obstruction.

Cited by 6 publications

References 0 publications

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Efficacy of a physical exercise training programme COPD in primary care: study protocol of a randomized controlled trial

Pulmonary rehabilitation for chronic obstructive pulmonary disease

Contact Info

Product

Resources

About