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Cost effectiveness of two online interventions supporting self-care for eczema for parents/carers and young people

Cost effectiveness of two online interventions supporting self-care for eczema for parents/carers and young people
Cost effectiveness of two online interventions supporting self-care for eczema for parents/carers and young people
Objective: to estimate the cost-effectiveness of online behavioural interventions (EczemaCareOnline.org.uk) designed to support eczema self-care management for parents/carers and young people from an NHS perspective.

Methods: two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specified confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomised controlled trials, recruiting through primary care. Trial 1 recruited 340 parents/carers of children aged 0-12 years and Trial 2 337 young people aged 13-25 years with eczema scored ≥5 on Patient-Oriented Eczema Measure (POEM). Participants were randomised (1:1) to online intervention plus usual care or usual care alone. Resource use, collected via medical notes review, was valued using published unit costs in UK £Sterling 2021. Quality-of-life was elicited using proxy CHU-9D in Trial 1 and self-report EQ-5D-5L in Trial 2.

Results: the intervention was dominant (cost saving and more effective) with a high probability of cost-effectiveness (>68%) in most analyses. The exception was the complete case cost-utility analysis for Trial 1 (omitting participants with children aged <2), with adjusted incremental cost savings of -£34.15 (95% CI -104.54 to 36.24) and incremental QALYs of -0.003 (95% CI -0.021 to 0.015) producing an incremental cost per QALY of £12,466.

In the secondary combined (Trials 1 and 2) cost-effectiveness analysis the adjusted incremental cost was -£20.35 (95% CI -55.41 to 14.70), with incremental success (≥2-point change on POEM) of 10.3% (95% CI 2.3% to 18.1%).

Conclusion: the free at point of use online eczema self-management intervention was low cost to run and cost-effective.
Atopic dermatitis, Atopic eczema, Cost-effectiveness, Economic evaluation, Economic evaluation,, Online interventions, atopic dermatitis, atopic eczema,, cost-effectiveness,, online interventions,
1618-7598
1165-1176
Sach, Tracey H.
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Onoja, Mary
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Clarke, Holly
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Santer, Miriam
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Muller, Ingrid
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Becque, Taeko
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Stuart, Beth
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Hooper, Julie
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Steele, Mary
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Wilczynska, Sylvia
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Ridd, Matthew J.
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Roberts, Amanda
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Ahmed, Amina
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Yardley, Lucy
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Little, Paul
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Greenwell, Kate
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Sivyer, Katy
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Nuttall, Jacqui
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Griffiths, Gareth
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Lawton, Sandra
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Langan, Sinéad M.
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Howells, Laura
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Leighton, Paul
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Williams, Hywel C.
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Thomas, Kim S.
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Sach, Tracey H.
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Onoja, Mary
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Clarke, Holly
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Santer, Miriam
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Muller, Ingrid
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Becque, Taeko
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Stuart, Beth
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Hooper, Julie
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Steele, Mary
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Wilczynska, Sylvia
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Ridd, Matthew J.
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Roberts, Amanda
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Ahmed, Amina
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Yardley, Lucy
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Little, Paul
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Greenwell, Kate
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Sivyer, Katy
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Nuttall, Jacqui
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Griffiths, Gareth
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Lawton, Sandra
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Langan, Sinéad M.
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Howells, Laura
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Leighton, Paul
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Williams, Hywel C.
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Thomas, Kim S.
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Sach, Tracey H., Onoja, Mary, Clarke, Holly, Santer, Miriam, Muller, Ingrid, Becque, Taeko, Stuart, Beth, Hooper, Julie, Steele, Mary, Wilczynska, Sylvia, Ridd, Matthew J., Roberts, Amanda, Ahmed, Amina, Yardley, Lucy, Little, Paul, Greenwell, Kate, Sivyer, Katy, Nuttall, Jacqui, Griffiths, Gareth, Lawton, Sandra, Langan, Sinéad M., Howells, Laura, Leighton, Paul, Williams, Hywel C. and Thomas, Kim S. (2024) Cost effectiveness of two online interventions supporting self-care for eczema for parents/carers and young people. The European Journal of Health Economics, 25 (7), 1165-1176. (doi:10.1007/s10198-023-01649-9).

Record type: Article

Abstract

Objective: to estimate the cost-effectiveness of online behavioural interventions (EczemaCareOnline.org.uk) designed to support eczema self-care management for parents/carers and young people from an NHS perspective.

Methods: two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specified confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomised controlled trials, recruiting through primary care. Trial 1 recruited 340 parents/carers of children aged 0-12 years and Trial 2 337 young people aged 13-25 years with eczema scored ≥5 on Patient-Oriented Eczema Measure (POEM). Participants were randomised (1:1) to online intervention plus usual care or usual care alone. Resource use, collected via medical notes review, was valued using published unit costs in UK £Sterling 2021. Quality-of-life was elicited using proxy CHU-9D in Trial 1 and self-report EQ-5D-5L in Trial 2.

Results: the intervention was dominant (cost saving and more effective) with a high probability of cost-effectiveness (>68%) in most analyses. The exception was the complete case cost-utility analysis for Trial 1 (omitting participants with children aged <2), with adjusted incremental cost savings of -£34.15 (95% CI -104.54 to 36.24) and incremental QALYs of -0.003 (95% CI -0.021 to 0.015) producing an incremental cost per QALY of £12,466.

In the secondary combined (Trials 1 and 2) cost-effectiveness analysis the adjusted incremental cost was -£20.35 (95% CI -55.41 to 14.70), with incremental success (≥2-point change on POEM) of 10.3% (95% CI 2.3% to 18.1%).

Conclusion: the free at point of use online eczema self-management intervention was low cost to run and cost-effective.

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Accepted/In Press date: 14 November 2023
e-pub ahead of print date: 9 January 2024
Published date: 9 January 2024
Additional Information: Funding Information: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: no support from any organization other than the National Institute for Health and Care Research for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work, other than LH has received consultancy fees from the University of Oxford on an educational grant funded by Pfizer, unrelated to the submitted work. THS was a member of NIHR HTA Efficient Study Designs—2, HTA Efficient Study Designs Board, HTA End of Life Care and Add-on-Studies, HTA Primary Care Themed Call Board and the HTA Commissioning Board between 2013 and Dec 2019. She is a steering committee member of the UK Dermatology Clinical Trials Network and Chair of the NIHR Research for Patient Benefit Regional Advisory Panel for the East of England. THS had no part in the decision-making for funding this study. Funding Information: This study presents independent research funded by the National Institute for Health and Care Research (NIHR) under its Programme Grants for Applied Research programme (grant ref No RP-PG-0216–20007). Eczema Care Online (ECO) interventions were developed using LifeGuide software, which was partly funded by the NIHR Southampton Biomedical Research Centre (BRC). SiL was supported by a Wellcome senior research fellowship in clinical science (205039/Z/16/Z). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Keywords: Atopic dermatitis, Atopic eczema, Cost-effectiveness, Economic evaluation, Economic evaluation,, Online interventions, atopic dermatitis, atopic eczema,, cost-effectiveness,, online interventions,

Identifiers

Local EPrints ID: 486108
URI: http://eprints.soton.ac.uk/id/eprint/486108
ISSN: 1618-7598
PURE UUID: 6d327c3b-8d64-4cd1-9547-700204078559
ORCID for Tracey H. Sach: ORCID iD orcid.org/0000-0002-8098-9220
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Taeko Becque: ORCID iD orcid.org/0000-0002-0362-3794
ORCID for Mary Steele: ORCID iD orcid.org/0000-0003-2595-3855
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Kate Greenwell: ORCID iD orcid.org/0000-0002-3662-1488
ORCID for Katy Sivyer: ORCID iD orcid.org/0000-0003-4349-0102
ORCID for Gareth Griffiths: ORCID iD orcid.org/0000-0002-9579-8021

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Date deposited: 09 Jan 2024 17:51
Last modified: 21 Nov 2024 03:06

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Contributors

Author: Tracey H. Sach ORCID iD
Author: Mary Onoja
Author: Holly Clarke
Author: Miriam Santer ORCID iD
Author: Ingrid Muller
Author: Taeko Becque ORCID iD
Author: Beth Stuart
Author: Julie Hooper
Author: Mary Steele ORCID iD
Author: Sylvia Wilczynska
Author: Matthew J. Ridd
Author: Amanda Roberts
Author: Amina Ahmed
Author: Lucy Yardley ORCID iD
Author: Paul Little ORCID iD
Author: Kate Greenwell ORCID iD
Author: Katy Sivyer ORCID iD
Author: Jacqui Nuttall
Author: Sandra Lawton
Author: Sinéad M. Langan
Author: Laura Howells
Author: Paul Leighton
Author: Hywel C. Williams
Author: Kim S. Thomas

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