Long-term (3-year) economic evaluation of intensive patient education for self-management during the first year in new asthmatics.
Patient education and self-management programmes have proved effective in many studies with short follow-up periods.
We studied the 3-year cost-effectiveness of an intensive programme of patient education and supervision for self-management.
The study consisted of 162 consecutive newly diagnosed asthmatics who were randomized either into an intervention group (IG) receiving intensive patient education and supervision for self-management at an outpatient clinic during the first year, or a control group (CG) receiving conventional education at the baseline visits only.
Both groups had 2 additional years of follow-up.
Lung functions and health-related quality of life (HRQOL) were measured.
Extra direct and indirect costs were recorded.
At 3 years the differences in forced expiratory volume in 1 s (FEV1) and in peak expiratory flow (PEF) were significantly better in the IG being in (% predicted) respectively 5.3 (95% CI 0.6-10.0) and 4.4 (95% CI 0.1-8.7), (P<0.05).
The airway responsiveness (PD15) did not differ significantly, but the improvement from baseline to 3 years was significantly greater in the IG, being 0.40 dose steps (95% CI 0.05-0.75) (P<0.05).
HRQOL scores did not differ significantly.
The risk for sickness day was less in the IG with a RR of 0.6 (95% Cl 0.50-0.69) (P=0.000) and among patients who used the PEF meter.
The compliance was similar in both groups when measured by the PEF-based self-management. (...)
Mots-clés Pascal : Asthme, Education santé, Malade, Analyse coût efficacité, Economie santé, VEMS, Long terme, Traitement, Homme, Appareil respiratoire pathologie, Bronchopneumopathie obstructive
Mots-clés Pascal anglais : Asthma, Health education, Patient, Cost efficiency analysis, Health economy, Maximal expiratory volume per second, Long term, Treatment, Human, Respiratory disease, Obstructive pulmonary disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0253969
Code Inist : 002B11B. Création : 16/11/1999.