title: Resource utilisation and direct costs in patients with recently diagnosed fibromyalgia who are offered one of three different interventions in a randomised pragmatic trial.
abstract: The purpose of this study is to understand the course of costs over a 2-year period in a cohort of recently diagnosed fibromyalgia (FM) patients receiving different treatment strategies. Following the diagnosis, patients were randomly assigned to a multidisciplinary programme (MD), aerobic exercise (AE) or usual care (UC) without being aware of alternative interventions. Time between diagnosis and start of treatment varied between patients. Resource utilisation, health care costs and costs for patients and families were collected through cost diaries. Mixed linear model analyses (MLM) examined the course of costs over time. Linear regression was used to explore predictors of health care costs in the post-intervention period. Two hundred three participants, 90 % women, mean (SD) age 41.7 (9.8) years, were included in the cohort. Intervention costs per patient varied from €864 to 1392 for MD and were €121 for AE. Health care costs (excluding intervention costs) decreased after diagnosis, but before the intervention in each group, and increased again afterwards to the level close to the diagnostic phase. In contrast, patient and family costs slightly increased over time in all groups without initial decrease immediately after diagnosis. Annualised health care costs post-intervention varied between €1872 and 2310 per patient and were predicted by worse functioning and high health care costs at diagnosis. In patients with FM, health care costs decreased following the diagnosis by a rheumatologist. Offering patients a specific intervention after diagnosis incurred substantial costs while having only marginal effects on costs.
authors.affiliation: Department of Patient and Care, Maastricht University Medical Centre, PO box 5800, 6202 AZ, Maastricht, The Netherlands. yvonne.eijk.hustings@mumc.nl.|CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. yvonne.eijk.hustings@mumc.nl.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: van Eijk-Hustings
authors.affiliation: CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Mariëlle
authors.initials: M
authors.lastname: Kroese
authors.affiliation: Department of Biostatistics, Hasselt University, Hasselt, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: Creemers
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Academic Medical Centre University of Amsterdam, Atrium Medical Centre Heerlen, Heerlen, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Landewé
authors.affiliation: CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.|Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Boonen
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000191:economics*; D005260:Female; D005356:Fibromyalgia / Q000191:economics / Q000628:therapy*; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life
keywords: Fibromyalgia; Health care costs; Health resources; Intervention; Utilisation