title: Clinical outcomes and cost-effectiveness of an externally applied electroceutical device in managing venous leg ulcers in clinical practice in the UK.
abstract: OBJECTIVE
  To estimate the cost-effectiveness of treating patients with a venous leg ulcer (VLU) with an externally applied electroceutical (EAE) device, plus dressings and compression bandaging or continuing with their previous care plan, from the perspective of the National Health Service (NHS) in the UK.
  
  
  METHODS
  This was a prospective, single-arm, non-blinded, clinical and economic evaluation of EAE therapy performed in 2013/14. Patients' VLUs were treated with six active units of EAE therapy (each unit for two days) plus dressings and compression bandaging over a period of 12 days. Afterwards, patients were managed with a combination of dressings and bandages. Each patient acted as their own control so that clinical outcomes, resource use and costs associated with the wound over 12 months before the start of EAE therapy were retrospectively compared with the first 12 months after the start of treatment. The relative cost-effectiveness of EAE therapy was estimated at 2013/14 prices.
  
  
  RESULTS
  Within 12 months of starting EAE therapy 77% of all wounds healed and the other 23% improved. This difference in effectiveness between the 12-months period before and after EAE therapy was estimated to yield a 12% improvement in health gain of 0.09 QALYs (p<0.01), a 34% reduction in the requirement for nurse visits (from a mean 50.7 to 33.3 visits per patient) and a 26% reduction in the number of dressings. This resulted in an 11% reduction in the NHS cost of VLU management over 12 months after the start of treatment when compared with the previous 12 months (from £1,981 to £1,754 per patient). Hence, use of EAE therapy was found to be a dominant treatment (i.e. improved outcome for less cost).
  
  
  CONCLUSIONS
  Within the study's limitations, use of the EAE device potentially affords the NHS a cost-effective treatment for managing VLUs when compared with patients remaining on their previous care plan.
authors.affiliation: Director of Catalyst, Visiting Professor of Health Economics, Researcher Assistant, Catalyst Health Economics Consultants, Northwood, Middlesex, UK.|Director of Catalyst, Visiting Professor of Health Economics, Faculty of Life Sciences and Medicine, King's College, London, UK.
authors.forename: J F
authors.initials: JF
authors.lastname: Guest
authors.affiliation: Director of Catalyst, Visiting Professor of Health Economics, Researcher Assistant, Catalyst Health Economics Consultants, Northwood, Middlesex, UK.
authors.forename: N
authors.initials: N
authors.lastname: Ayoub
authors.affiliation: Tissue Viability Nurse The Willows Clinic (Bromley Healthcare CIC), Chislehurst, UK.
authors.forename: T
authors.initials: T
authors.lastname: Greaves
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058128:Compression Bandages / Q000191:economics*; D003362:Cost-Benefit Analysis; D004599:Electric Stimulation Therapy / Q000191:economics*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000191:economics* / Q000628:therapy*; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013222:State Medicine / Q000191:economics*; D016896:Treatment Outcome; D006113:United Kingdom; D014945:Wound Healing
keywords: Accel-Heal; UK; compression; cost-effectiveness; economic evaluation; electroceutical therapy; venous leg ulcer