title: An economic evaluation of a self-management programme of activity, coping and education for patients with chronic obstructive pulmonary disease.
abstract: The aim was to undertake a cost-utility analysis of a self-management programme of activity, coping and education (SPACE) for chronic obstructive pulmonary disease (COPD). The analysis was conducted alongside a six-month randomized controlled trial in 30 primary care settings. The economic analysis used data from 184 patients with confirmed diagnosis of COPD, forced expiratory volume in one second/forced vital capacity ratio <0.7 and with grade 2-5 on the Medical Research Council dyspnoea scale. Participants received either a self-management programme consisting of an education manual (SPACE for COPD) and consultation or usual care. Six-month costs were estimated from the National Health Service and Personal Social Services perspective and quality-adjusted life years (QALYs) were calculated based on patient responses at baseline and six months.The mean difference in costs between usual care and SPACE FOR COPD programme was -£27.18 (95% confidence interval (CI); -£122.59 to £68.25) while mean difference in QALYs was -0.10 (95% CI; -0.17 to -0.02). The results suggest that the intervention is more costly and more effective than usual care. The probability of the intervention being cost-effective was 97% at a threshold of £20,000/QALY gained. We conclude that the SPACE FOR COPD programme is cost-effective compared to usual care.
authors.affiliation: Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK m.s.dritsaki@warwick.ac.uk.
authors.forename: Melina
authors.initials: M
authors.lastname: Dritsaki
authors.affiliation: Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Vicki
authors.initials: V
authors.lastname: Johnson-Warrington
authors.affiliation: Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Katy
authors.initials: K
authors.lastname: Mitchell
authors.affiliation: Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Sally
authors.initials: S
authors.lastname: Singh
authors.affiliation: Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Rees
mesh_terms: D000223:Adaptation, Psychological; D003362:Cost-Benefit Analysis; D005541:Forced Expiratory Volume; D006801:Humans; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000628:therapy*; D012648:Self Care / Q000191:economics*
keywords: COPD; RCT; cost-effectiveness analysis; cost-utility analysis; education; self-management