Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial

Jan Sørensen; Bente Appel Esbensen; Mette Aadahl; Merete Lund Hetland; Tanja Thomsen

doi:10.1136/rmdopen-2022-002304

Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial

Jan Sørensen, Bente Appel Esbensen, Mette Aadahl, Merete Lund Hetland, Tanja Thomsen

4 Citations (Scopus)

Abstract

OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of an individually tailored intervention consisting of motivational counselling and text message reminders to reduce sedentary behaviour in comparison with usual lifestyle in patients with rheumatoid arthritis (RA).

METHODS: RA patients (n=150) were randomised to the intervention or control group. Costs of the intervention and healthcare utilisation during a 22-month follow-up period were reported. Outcomes were objectively measured as 24 hours/7 days sitting time and self-reported Health Assessment Questionnaire (HAQ) and EQ-5D scores at baseline, and 16 weeks, 10 and 22 months after baseline. Cost-effectiveness was reported as incremental cost-effectiveness ratios and statistical uncertainty presented as cost-effectiveness acceptability curves.

RESULTS: The intervention cost was estimated at €387 per participant. The mean incremental 22-month healthcare cost was €-1165 (95% bootstrap CI -5613 to 3283). An incremental 20%-point of the participants (CI 10.4% to 29.6%) reduced their daily sitting time more than 50 min and 36%-point reported better HAQ scores (change>0.22). The time-weighted health utilities (quality-adjusted life years (QALYs)) increased by 0.10 (CI 0.02 to 0.18) and 0.11 (CI 0.04 to 0.19) for EQ-5D index and EQ-VAS, respectively. The intervention dominated usual lifestyle by offering better outcomes and lower costs. With a threshold value of €30 000/QALY the intervention has a probability of 95% of being cost-effective.

CONCLUSION: This protocolised cost-effectiveness analysis showed that an individually tailored intervention aimed at reducing sedentary behaviour in patients with RA is improving participants' 22-month health status and reducing healthcare costs. These results suggest that the intervention should be implemented in routine rheumatology care.

TRIAL REGISTRATION NUMBER: NCT01969604.

Original language	English
Article number	e002304
Journal	RMD Open
Volume	8
Issue number	2
ISSN	2056-5933
DOIs	https://doi.org/10.1136/rmdopen-2022-002304
Publication status	Published - Jul 2022

Keywords

Arthritis, Rheumatoid/therapy
Cost-Benefit Analysis
Counseling
Humans
Sedentary Behavior
Text Messaging
Economics
Arthritis, Rheumatoid
Health services research
Patient Reported Outcome Measures

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10.1136/rmdopen-2022-002304

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@article{15e19cab244e4a6c8c838549b24cc984,

title = "Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial",

abstract = "OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of an individually tailored intervention consisting of motivational counselling and text message reminders to reduce sedentary behaviour in comparison with usual lifestyle in patients with rheumatoid arthritis (RA).METHODS: RA patients (n=150) were randomised to the intervention or control group. Costs of the intervention and healthcare utilisation during a 22-month follow-up period were reported. Outcomes were objectively measured as 24 hours/7 days sitting time and self-reported Health Assessment Questionnaire (HAQ) and EQ-5D scores at baseline, and 16 weeks, 10 and 22 months after baseline. Cost-effectiveness was reported as incremental cost-effectiveness ratios and statistical uncertainty presented as cost-effectiveness acceptability curves.RESULTS: The intervention cost was estimated at €387 per participant. The mean incremental 22-month healthcare cost was €-1165 (95% bootstrap CI -5613 to 3283). An incremental 20%-point of the participants (CI 10.4% to 29.6%) reduced their daily sitting time more than 50 min and 36%-point reported better HAQ scores (change>0.22). The time-weighted health utilities (quality-adjusted life years (QALYs)) increased by 0.10 (CI 0.02 to 0.18) and 0.11 (CI 0.04 to 0.19) for EQ-5D index and EQ-VAS, respectively. The intervention dominated usual lifestyle by offering better outcomes and lower costs. With a threshold value of €30 000/QALY the intervention has a probability of 95% of being cost-effective.CONCLUSION: This protocolised cost-effectiveness analysis showed that an individually tailored intervention aimed at reducing sedentary behaviour in patients with RA is improving participants' 22-month health status and reducing healthcare costs. These results suggest that the intervention should be implemented in routine rheumatology care.TRIAL REGISTRATION NUMBER: NCT01969604.",

keywords = "Arthritis, Rheumatoid/therapy, Cost-Benefit Analysis, Counseling, Humans, Sedentary Behavior, Text Messaging, Economics, Arthritis, Rheumatoid, Health services research, Patient Reported Outcome Measures",

author = "Jan S{\o}rensen and Esbensen, {Bente Appel} and Mette Aadahl and Hetland, {Merete Lund} and Tanja Thomsen",

note = "COPECARE {\textcopyright} Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2022",

month = jul,

doi = "10.1136/rmdopen-2022-002304",

language = "English",

volume = "8",

journal = "RMD Open",

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T1 - Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial

AU - Sørensen, Jan

AU - Esbensen, Bente Appel

AU - Aadahl, Mette

AU - Hetland, Merete Lund

AU - Thomsen, Tanja

N1 - COPECARE © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2022/7

Y1 - 2022/7

N2 - OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of an individually tailored intervention consisting of motivational counselling and text message reminders to reduce sedentary behaviour in comparison with usual lifestyle in patients with rheumatoid arthritis (RA).METHODS: RA patients (n=150) were randomised to the intervention or control group. Costs of the intervention and healthcare utilisation during a 22-month follow-up period were reported. Outcomes were objectively measured as 24 hours/7 days sitting time and self-reported Health Assessment Questionnaire (HAQ) and EQ-5D scores at baseline, and 16 weeks, 10 and 22 months after baseline. Cost-effectiveness was reported as incremental cost-effectiveness ratios and statistical uncertainty presented as cost-effectiveness acceptability curves.RESULTS: The intervention cost was estimated at €387 per participant. The mean incremental 22-month healthcare cost was €-1165 (95% bootstrap CI -5613 to 3283). An incremental 20%-point of the participants (CI 10.4% to 29.6%) reduced their daily sitting time more than 50 min and 36%-point reported better HAQ scores (change>0.22). The time-weighted health utilities (quality-adjusted life years (QALYs)) increased by 0.10 (CI 0.02 to 0.18) and 0.11 (CI 0.04 to 0.19) for EQ-5D index and EQ-VAS, respectively. The intervention dominated usual lifestyle by offering better outcomes and lower costs. With a threshold value of €30 000/QALY the intervention has a probability of 95% of being cost-effective.CONCLUSION: This protocolised cost-effectiveness analysis showed that an individually tailored intervention aimed at reducing sedentary behaviour in patients with RA is improving participants' 22-month health status and reducing healthcare costs. These results suggest that the intervention should be implemented in routine rheumatology care.TRIAL REGISTRATION NUMBER: NCT01969604.

AB - OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of an individually tailored intervention consisting of motivational counselling and text message reminders to reduce sedentary behaviour in comparison with usual lifestyle in patients with rheumatoid arthritis (RA).METHODS: RA patients (n=150) were randomised to the intervention or control group. Costs of the intervention and healthcare utilisation during a 22-month follow-up period were reported. Outcomes were objectively measured as 24 hours/7 days sitting time and self-reported Health Assessment Questionnaire (HAQ) and EQ-5D scores at baseline, and 16 weeks, 10 and 22 months after baseline. Cost-effectiveness was reported as incremental cost-effectiveness ratios and statistical uncertainty presented as cost-effectiveness acceptability curves.RESULTS: The intervention cost was estimated at €387 per participant. The mean incremental 22-month healthcare cost was €-1165 (95% bootstrap CI -5613 to 3283). An incremental 20%-point of the participants (CI 10.4% to 29.6%) reduced their daily sitting time more than 50 min and 36%-point reported better HAQ scores (change>0.22). The time-weighted health utilities (quality-adjusted life years (QALYs)) increased by 0.10 (CI 0.02 to 0.18) and 0.11 (CI 0.04 to 0.19) for EQ-5D index and EQ-VAS, respectively. The intervention dominated usual lifestyle by offering better outcomes and lower costs. With a threshold value of €30 000/QALY the intervention has a probability of 95% of being cost-effective.CONCLUSION: This protocolised cost-effectiveness analysis showed that an individually tailored intervention aimed at reducing sedentary behaviour in patients with RA is improving participants' 22-month health status and reducing healthcare costs. These results suggest that the intervention should be implemented in routine rheumatology care.TRIAL REGISTRATION NUMBER: NCT01969604.

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KW - Cost-Benefit Analysis

KW - Counseling

KW - Humans

KW - Sedentary Behavior

KW - Text Messaging

KW - Economics

KW - Arthritis, Rheumatoid

KW - Health services research

KW - Patient Reported Outcome Measures

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U2 - 10.1136/rmdopen-2022-002304

DO - 10.1136/rmdopen-2022-002304

M3 - Journal article

C2 - 35853676

SN - 2056-5933

VL - 8

JO - RMD Open

JF - RMD Open

IS - 2

M1 - e002304

ER -

Cost-effectiveness of motivational counselling and text reminders in patients with rheumatoid arthritis: results based on a randomised clinical trial

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