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Assessing the cost‐effectiveness of RT Prepare: A radiation therapist–delivered intervention for reducing psychological distress prior to radiotherapy
Author(s) -
Youens David,
Halkett Georgia,
Wright Cameron,
O'Connor Moira,
Schofield Penelope,
Jefford Michael,
Aranda Sanchia,
Kane Robert,
Moorin Rachael
Publication year - 2019
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5065
Subject(s) - medicine , distress , intervention (counseling) , quality of life (healthcare) , anxiety , hospital anxiety and depression scale , physical therapy , cost effectiveness , depression (economics) , clinical psychology , nursing , psychiatry , risk analysis (engineering) , economics , macroeconomics
Objective To determine the cost‐effectiveness of RT Prepare in reducing breast cancer patients' psychological distress before treatment, compared with usual care. Methods RT Prepare, an intervention involving patient education and support consultations with a radiation therapist (RT), was implemented at three Australian sites (Australian New Zealand Clinical Trials Registration: ACTRN12611001000998). The primary outcome was change in psychological distress using the Hospital Anxiety and Depression Scale (HADS); secondary outcomes were changes in quality of life (QoL) and additional health service use. Costs (2015 $AU) included consultation time and training delivery. Between‐group comparisons of HADS and QoL used generalised linear mixed models, and comparisons of health service use used negative binomial regression. Incremental cost‐effectiveness ratios (ICERs) indicated mean costs per 1‐point decrease in HADS score. Sensitivity analyses explored variation in facility size and uncertainty in intervention effectiveness. Results Among 218 controls and 189 intervention participants, the intervention significantly lowered HADS scores at treatment commencement (adjusted mean difference 1.06 points). There was no significant effect on QoL or additional service use. Mean intervention costs were AU$171 per participant (US$130, €119) mostly related to RT training (approximately AU$142 (US$108, €99). An ICER of $158 (US$120, €110) was estimated. Cost‐effectiveness improved in a sensitivity analysis representing a large facility with higher patient numbers. Conclusion This study provides new data on the cost‐effectiveness of an RT‐delivered intervention to reduce psychological distress prior to treatment, which will be useful to inform delivery of similar services. As most costs were upfront, cost‐effectiveness would likely improve if implemented as standard care.