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Cost‐Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infection in Long‐Term Care Facilities: Economic Evaluation with a Randomized Controlled Trial
Author(s) -
Hout Wilbert B.,
Caljouw Monique A. A.,
Putter Hein,
Cools Herman J. M.,
Gussekloo Jacobijn
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12595
Subject(s) - medicine , randomized controlled trial , confidence interval , cost effectiveness , relative risk , quality of life (healthcare) , urinary system , incidence (geometry) , quality adjusted life year , intensive care medicine , risk analysis (engineering) , physics , nursing , optics
Objectives To investigate whether the preventive use of cranberry capsules in long‐term care facility ( LTCF ) residents is cost‐effective depending on urinary tract infection ( UTI ) risk. Design Economic evaluation with a randomized controlled trial. Setting Long‐term care facilities. Participants LTCF residents (N = 928, 703 female, median age 84), stratified according to UTI risk. Measurements UTI incidence (clinically or strictly defined), survival, quality of life, quality‐adjusted life years ( QALY s), and costs. Results In the weeks after a clinical UTI , participants showed a significant but moderate deterioration in quality of life, survival, care dependency, and costs. In high‐ UTI ‐risk participants, cranberry costs were estimated at €439 per year (1.00 euro = 1.37 U.S. dollar), which is €3,800 per prevented clinically defined UTI (95% confidence interval = €1,300–infinity). Using the strict UTI definition, the use of cranberry increased costs without preventing UTI s. Taking cranberry capsules had a 22% probability of being cost‐effective compared with placebo (at a willingness to pay of €40,000 per QALY ). In low‐ UTI ‐risk participants, use of cranberry capsules was only 3% likely to be cost‐effective. Conclusion In high‐ UTI ‐risk residents, taking cranberry capsules may be effective in preventing UTI s but is not likely to be cost‐effective in the investigated dosage, frequency, and setting. In low‐ UTI ‐risk LTCF residents, taking cranberry capsules twice daily is neither effective nor cost‐effective.