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Open Access 01-12-2013 | Research article

Cost-effectiveness of supported self-management for CFS/ME patients in primary care

Authors: Gerry Richardson, David Epstein, Carolyn Chew-Graham, Christopher Dowrick, Richard P Bentall, Richard K Morriss, Sarah Peters, Lisa Riste, Karina Lovell, Graham Dunn, Alison J Wearden, the FINE Trial Writing group on behalf of the FINE Trial group

Published in: BMC Primary Care | Issue 1/2013

Abstract

Background

Nurse led self-help treatments for people with chronic fatigue syndrome/myalgic encephalitis (CFS/ME) have been shown to be effective in reducing fatigue but their cost-effectiveness is unknown.

Methods

Cost-effectiveness analysis conducted alongside a single blind randomised controlled trial comparing pragmatic rehabilitation (PR) and supportive listening (SL) delivered by primary care nurses, and treatment as usual (TAU) delivered by the general practitioner (GP) in North West England. A within trial analysis was conducted comparing the costs and quality adjusted life years (QALYs) measured within the time frame of the trial. 296 patients aged 18 and over with CFS/ME diagnosed using the Oxford criteria were included in the cost-effectiveness analysis.

Results

Treatment as usual is less expensive and leads to better patient outcomes compared with Supportive Listening. Treatment as usual is also less expensive than Pragmatic Rehabilitation. PR was effective at reducing fatigue in the short term, but the impact of the intervention on QALYs was uncertain. However, based on the results of this trial, PR is unlikely to be cost-effective in this patient population.

Conclusions

This analysis does not support the introduction of SL. Any benefits generated by PR are unlikely to be of sufficient magnitude to warrant recommending PR for this patient group on cost-effectiveness grounds alone. However, dissatisfaction with current treatment options means simply continuing with ‘treatment as usual’ in primary care is unlikely to be acceptable to patients and practitioners.

Trial registration

The trial registration number is IRCTN74156610

Available only for authorised users

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2296/14/12/prepub

Title: Cost-effectiveness of supported self-management for CFS/ME patients in primary care
Authors: Gerry Richardson
David Epstein
Carolyn Chew-Graham
Christopher Dowrick
Richard P Bentall
Richard K Morriss
Sarah Peters
Lisa Riste
Karina Lovell
Graham Dunn
Alison J Wearden
the FINE Trial Writing group on behalf of the FINE Trial group
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Primary Care / Issue 1/2013
Electronic ISSN: 2731-4553
DOI: https://doi.org/10.1186/1471-2296-14-12

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cost-effectiveness of supported self-management for CFS/ME patients in primary care

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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