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Mud‐Bath Therapy in Addition to Usual Care in Bilateral Knee Osteoarthritis: An Economic Evaluation Alongside a Randomized Controlled Trial
Author(s) -
Ciani Oriana,
Pascarelli Nicola Antonio,
Giannitti Chiara,
Galeazzi Mauro,
Meregaglia Michela,
Fattore Giovanni,
Fioravanti Antonella
Publication year - 2017
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23116
Subject(s) - medicine , randomized controlled trial , osteoarthritis , quality of life (healthcare) , physical therapy , quality adjusted life year , cost effectiveness , surgery , risk analysis (engineering) , alternative medicine , nursing , pathology
Objective To perform a cost‐effectiveness analysis of mud‐bath therapy (MBT) in addition to usual treatment compared to usual treatment alone in patients with bilateral knee osteoarthritis (OA). Methods An economic evaluation alongside a randomized controlled trial was conducted. Patients were randomly assigned to receive either a 2‐week cycle of MBT in addition to their usual treatment or to continue routine care alone. The EuroQol 5‐domain questionnaire was administered at baseline, 2 weeks, and at 3, 6, 9, and 12 months. Direct health care resource consumption data up until 12 months were derived from a daily diary given to patients and returned at prescheduled followup visits. Results A total of 103 patients were included (n = 53 for MBT patients; n = 50 for controls). Overall, patients in the MBT group accrued mean ± SD 0.835 ± 0.10 quality‐adjusted life years (QALYs) compared to 0.753 ± 0.11 in the control group ( P < 0.001). Average direct costs per patient (€303 versus €975; P < 0.001) were higher in the control group, primarily because of hospitalization for total knee replacement and use of intraarticular hyaluronic acid. Bootstrapping replications of costs and QALY sample distributions consistently indicated that the MBT therapy combined with standard therapy represents a dominant strategy as compared with standard therapy alone. The probability of MBT being cost‐effective at standard cost‐effectiveness thresholds (e.g., €20,000/QALY) is 100%. Conclusion The results of this cost‐effectiveness analysis support the use of MBT as midterm complementary therapy in the management of knee OA.