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Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: follow up of a randomised controlled trial

Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: follow up of a randomised controlled trial
Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: follow up of a randomised controlled trial
Objective: To establish the cost effectiveness of nurse led secondary prevention clinics for coronary heart disease based on four years' follow up of a randomised controlled trial.

Design: Cost effectiveness analysis.

Setting: 19 general practices in north east Scotland.

Participants: 1343 patients (673 in intervention group and 670 in control group, as originally randomised) aged under 80 years with a diagnosis of coronary heart disease but without terminal illness or dementia and not housebound.

Intervention: Nurse led clinics to promote medical and lifestyle components of secondary prevention.

Main outcome measures: Costs of clinics; overall costs to health service; and cost per life year and per quality adjusted life year (QALY) gained, expressed as incremental gain in intervention group compared with control group.

Results: The cost of the intervention (clinics and drugs) was £136 ($254; 195) per patient higher (1998-9 prices) in the intervention group, but the difference in other NHS costs, although lower for the intervention group, was not statistically significant. Overall, 28 fewer deaths occurred in the intervention group leading to a gain in mean life years per patient of 0.110 and of 0.124 QALYs. The incremental cost per life year saved was £1236 and that per QALY was £1097.

Conclusion: Nurse led clinics for the secondary prevention of coronary heart disease in primary care seem to be cost effective compared with most interventions in health care, with the main gains in life years saved.
0959-8138
707-710
Raftery, James P.
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Yao, Guiqing Lily
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Murchie, Peter
384bebcf-8de7-4136-9946-27bc34fb8c73
Campbell, Neil C.
75bc1bba-df6b-4d9b-ac29-c8dafc408723
Ritchie, Lewis D.
6bce073e-95be-4fea-91a4-c8d07e7bafe8
Raftery, James P.
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Yao, Guiqing Lily
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Murchie, Peter
384bebcf-8de7-4136-9946-27bc34fb8c73
Campbell, Neil C.
75bc1bba-df6b-4d9b-ac29-c8dafc408723
Ritchie, Lewis D.
6bce073e-95be-4fea-91a4-c8d07e7bafe8

Raftery, James P., Yao, Guiqing Lily, Murchie, Peter, Campbell, Neil C. and Ritchie, Lewis D. (2005) Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: follow up of a randomised controlled trial. BMJ, 330 (7493), 707-710. (doi:10.1136/bmj.38342.665417.8F).

Record type: Article

Abstract

Objective: To establish the cost effectiveness of nurse led secondary prevention clinics for coronary heart disease based on four years' follow up of a randomised controlled trial.

Design: Cost effectiveness analysis.

Setting: 19 general practices in north east Scotland.

Participants: 1343 patients (673 in intervention group and 670 in control group, as originally randomised) aged under 80 years with a diagnosis of coronary heart disease but without terminal illness or dementia and not housebound.

Intervention: Nurse led clinics to promote medical and lifestyle components of secondary prevention.

Main outcome measures: Costs of clinics; overall costs to health service; and cost per life year and per quality adjusted life year (QALY) gained, expressed as incremental gain in intervention group compared with control group.

Results: The cost of the intervention (clinics and drugs) was £136 ($254; 195) per patient higher (1998-9 prices) in the intervention group, but the difference in other NHS costs, although lower for the intervention group, was not statistically significant. Overall, 28 fewer deaths occurred in the intervention group leading to a gain in mean life years per patient of 0.110 and of 0.124 QALYs. The incremental cost per life year saved was £1236 and that per QALY was £1097.

Conclusion: Nurse led clinics for the secondary prevention of coronary heart disease in primary care seem to be cost effective compared with most interventions in health care, with the main gains in life years saved.

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More information

Published date: 2005

Identifiers

Local EPrints ID: 24478
URI: http://eprints.soton.ac.uk/id/eprint/24478
ISSN: 0959-8138
PURE UUID: a975f799-a0ac-4548-aa22-47c894e8f253

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Date deposited: 31 Mar 2006
Last modified: 08 Jan 2022 03:48

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Contributors

Author: Peter Murchie
Author: Neil C. Campbell
Author: Lewis D. Ritchie

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