title: Cost-effectiveness of cranberry capsules to prevent urinary tract infection in long-term care facilities: economic evaluation with a randomized controlled trial.
abstract: OBJECTIVE
  To investigate whether the preventive use of cranberry capsules in long-term care facility (LTCF) residents is cost-effective depending on urinary tract infection (UTI) risk.
  
  
  METHODS
  Economic evaluation with a randomized controlled trial.
  
  
  METHODS
  Long-term care facilities.
  
  
  METHODS
  LTCF residents (N = 928, 703 female, median age 84), stratified according to UTI risk.
  
  
  METHODS
  UTI incidence (clinically or strictly defined), survival, quality of life, quality-adjusted life years (QALYs), and costs.
  
  
  RESULTS
  In the weeks after a clinical UTI, participants showed a significant but moderate deterioration in quality of life, survival, care dependency, and costs. In high-UTI-risk participants, cranberry costs were estimated at €439 per year (1.00 euro = 1.37 U.S. dollar), which is €3,800 per prevented clinically defined UTI (95% confidence interval = €1,300-infinity). Using the strict UTI definition, the use of cranberry increased costs without preventing UTIs. Taking cranberry capsules had a 22% probability of being cost-effective compared with placebo (at a willingness to pay of €40,000 per QALY). In low-UTI-risk participants, use of cranberry capsules was only 3% likely to be cost-effective.
  
  
  CONCLUSIONS
  In high-UTI-risk residents, taking cranberry capsules may be effective in preventing UTIs but is not likely to be cost-effective in the investigated dosage, frequency, and setting. In low-UTI-risk LTCF residents, taking cranberry capsules twice daily is neither effective nor cost-effective.
authors.forename: Wilbert B
authors.initials: WB
authors.lastname: van den Hout
authors.forename: Monique A A
authors.initials: MA
authors.lastname: Caljouw
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Herman J M
authors.initials: HJ
authors.lastname: Cools
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002214:Capsules; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D008517:Phytotherapy / Q000191:economics*; D010919:Placebos; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control*; D029799:Vaccinium macrocarpon
chemical_list: D002214:Capsules; D010919:Placebos