Article

OBJECTIVE: To evaluate the cost effectiveness of a behavioural therapy
intervention shown to be clinically effective in comparison with usual care for
stroke patients with aphasia. DESIGN: Randomised controlled trial with comparison
of costs and calculation of incremental cost effectiveness ratio. SETTING:
Community. PARTICIPANTS: Participants identified as having low mood on either the
Visual Analog Mood Scale sad item (>/=50) or Stroke Aphasic Depression
Questionnaire Hospital version 21 (SADQH21) (>/=6) were recruited. INTERVENTIONS:
Participants were randomly allocated to behavioural therapy or usual care using
internet-based randomisation generated in advance of the study by a clinical
trials unit. MAIN MEASURES: Outcomes were assessed at six months after
randomisation, blind to group allocation. The costs were assessed from a service
use questionnaire. Effectiveness was defined as the change in SADQH21 scores and
a cost-effectiveness analysis was performed comparing the behavioural group with
the usual care control group. The cost analysis was undertaken from the
perspective of the UK NHS and Social Services. RESULTS: The greatest difference
was in home help costs where there was a saving of pound56.20 in the intervention
group compared to an increase of pound61.40 in the control group. At six months
the SADQH21 score for the intervention group was 17.3 compared to the control
group value of 20.4. This resulted in a mean increase of 0.7 in the control
group, compared to a mean significant different decrease of 6 in the intervention
group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the
cost per point reduction on the SADQH21 was pound263. CONCLUSION: Overall the
behavioural therapy was found to improve mood and resulted in some encouraging
savings in resource utilisation over the six months follow-up.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS