护士主导的教育和心理社会方案对慢性心力衰竭患者及其伴侣的成本效益。
Cost-effectiveness of a nurse-led education and psychosocial programme for patients with chronic heart failure and their partners.
机构信息
Thoracic and Vascular Nursing, Department of Medicine and Health Sciences, Linköping University, Division of Nursing Sciences, Linköping University, Linköping, Sweden.
出版信息
J Clin Nurs. 2013 Aug;22(15-16):2347-53. doi: 10.1111/j.1365-2702.2012.04246.x.
AIMS AND OBJECTIVES
This randomised controlled trial was conducted to estimate the cost-effectiveness of a nurse-led education and psychosocial support programme for patients with heart failure (HF) and their partners.
BACKGROUND
There are few studies evaluating cost-effectiveness of interventions among HF patient-partner dyads.
METHODS
Dyads randomised to the experimental group received nurse-led counselling, computer-based education and written materials aimed at developing problem-solving skills at two, six and 12 weeks after hospitalisation with HF exacerbation. The dyads in the control group received usual care. A cost-effectiveness analysis that included costs associated with staff time to deliver the intervention and travel costs was conducted at 12 months. Quality-adjusted life-year (QALY) weights for patients and partners were estimated by SF-6D.
RESULTS
A total of 155 dyads were included. The intervention cost was €223 per patient. Participants in both groups showed improvements in QALY weights after 12 months. However, no significant difference in QALY weights was found between the patients in the two groups, nor among their partners.
CONCLUSION
The intervention was not proven cost-effective, neither for patients nor for partners. The intervention, however, had trends (but not significant) effects on the patient-partner dyads, and by analysing the QALY gained from the dyad, a reasonable mean cost-effectiveness ratio was achieved.
RELEVANCE TO CLINICAL PRACTICE
The study shows trends of a cost-effective education and psychosocial care of HF patient-partner dyads.
目的
本随机对照试验旨在评估针对心力衰竭（HF）患者及其伴侣的护士主导的教育和心理社会支持计划的成本效益。
背景
评估 HF 患者-伴侣对干预措施的成本效益的研究很少。
方法
随机分配到实验组的患者-伴侣接受护士主导的咨询、基于计算机的教育和书面材料，旨在在 HF 恶化后 2、6 和 12 周发展解决问题的技能。对照组的患者-伴侣接受常规护理。在 12 个月时进行了包括与干预措施实施相关的人员时间和旅行费用在内的成本效益分析。使用 SF-6D 估计患者和伴侣的质量调整生命年（QALY）权重。
结果
共纳入 155 对患者-伴侣。每个患者的干预成本为 223 欧元。两组参与者在 12 个月后 QALY 权重均有所改善。然而，两组患者的 QALY 权重没有差异，他们的伴侣也没有差异。
结论
该干预措施对患者和伴侣均未被证明具有成本效益。然而，该干预措施对患者-伴侣对具有趋势（但不显著）影响，通过分析从对获得的 QALY，得出了一个合理的平均成本效益比。
临床实践相关性
该研究显示了针对 HF 患者-伴侣对的教育和心理社会护理具有成本效益的趋势。
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