title: ECONOMIC EVALUATION STUDIES OF SELF-MANAGEMENT INTERVENTIONS IN CHRONIC DISEASES: A SYSTEMATIC REVIEW.
abstract: BACKGROUND
  To our knowledge, there has been no overall systematic review focusing on the methodological quality of full economic evaluation studies of self-management interventions. Our objective was to systematically review the literature of full economic evaluation studies of self-management interventions in adult chronic patients and to investigate their methodological quality and cost-effectiveness.
  
  
  METHODS
  A data extraction form was developed to assess general and randomized controlled trial (RCT) -related characteristics, quality, of the RCTs, economic information and quality of the economic evaluation studies by means of a quality assessment (CHEC-list for trial-based studies, adjusted CHEC-list for model-based studies).
  
  
  RESULTS
  Twenty-three reports were found. Sixteen studies (73 percent) lack information on the control intervention(s). Only one study fulfilled all three criteria for quality of RCTs and five studies (23 percent) did not meet any of these criteria. This review included one model-based study; the other studies were trial-based economic evaluation studies based on a RCT. Eight studies (35 percent) used a societal perspective and 12 (60 percent) synthesized costs and effects. Seven studies were categorized into the highest category (<15 score), nine studies into the "moderate" group (9-14 score), six studies received a "low" score (<8) on the CHEC-list. Eighteen studies found the self-management intervention(s) to be cost-effective compared with other interventions Conclusions: Self-management interventions for adult chronic patients were heterogeneous and there was no clear, well-considered definition of self-management. Overall, the methodological quality of the full economic evaluation studies was moderate and, therefore, cost-effectiveness results must be interpreted with caution. Future research will benefit from further improvements in methodological quality of both economic study design and analysis, as well as a taxonomy for describing self-management interventions and their contents.
authors.affiliation: CAPHRI,School for Public Health and Primary Care,Department of Health Services Research,Faculty of Health, Medicine and Life Sciences;Maastricht University.
authors.forename: Mitchel
authors.initials: M
authors.lastname: van Eeden
authors.affiliation: Department of Psychiatry & Neuropsychology,Faculty of Health, Medicine & Life Sciences MHeNS,School for Mental Health & Neuroscience;Maastricht University.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: van Heugten
authors.affiliation: CAPHRI,School for Public Health and Primary Care,Department of Health Services Research,Faculty of Health, Medicine and Life Sciences;Maastricht University.
authors.forename: Ghislaine A P G
authors.initials: GA
authors.lastname: van Mastrigt
authors.affiliation: CAPHRI,School for Public Health and Primary Care,Department of Health Services Research,Faculty of Health, Medicine and Life Sciences;Maastricht University.
authors.forename: Silvia M A A
authors.initials: SM
authors.lastname: Evers
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D003362:Cost-Benefit Analysis; D006801:Humans; D017059:Models, Econometric; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000191:economics* / Q000379:methods*
keywords: Chronic health care; Economic evaluation; Self-management; Systematic review