Larsen Marie H, Wahl Astrid K, Krogstad Anne-Lene, Aas Eline
Department of Health Sciences, Institute of Health and Society, Medical Faculty, University of Oslo, Oslo, Norway.
Acta Derm Venereol. 2016 Jun 15;96(5):664-8. doi: 10.2340/00015555-2331.
There are few studies evaluating the cost-effectiveness of self-management interventions for patients with psoriasis. Motivational interviewing (MI) as a telephone follow-up after climate-heliotherapy was effective on several clinical parameters, but its cost-effectiveness is unknown. A cost-utility analysis was conducted alongside a randomized controlled trial (RCT) comparing MI with usual care. A total of 169 Norwegian patients were included. A within-trial analysis compared the costs and quality-adjusted life years (QALYs). Utilities were measured with the 15D instrument, supplemented with Dermatological Life Quality Index (DLQI). A time-integrated summary score defined the clinical effects. QALYs were adjusted for baseline differences. MI provided equivalent quality of life and utility (15D: -0.0022 QALYs (95% Cl -0.02, 0.01), p = 0.77, and DLQI: -0.62 QALYs (95%CI -0.65, 0.41), p = 0.24, at lower costs €-1103 (-2293, 87), p = 0.058, compared with treatment-as-usual. The MI intervention was thus cost-effective. This result was more evident when using the DLQI as outcome measure compared with 15D.
评估银屑病患者自我管理干预措施成本效益的研究较少。动机性访谈（MI）作为气候日光疗法后的电话随访，对几个临床参数有效，但其成本效益尚不清楚。在一项将MI与常规护理进行比较的随机对照试验（RCT）中进行了成本效用分析。共纳入169名挪威患者。试验内分析比较了成本和质量调整生命年（QALY）。使用15D工具测量效用，并辅以皮肤病生活质量指数（DLQI）。时间综合总结评分定义临床效果。对QALY进行基线差异调整。与常规治疗相比，MI在较低成本下（-1103欧元（-2293,87），p = 0.058）提供了相当的生活质量和效用（15D：-0.0022 QALY（95%CI -0.02,0.01），p = 0.77；DLQI：-0.62 QALY（95%CI -0.65,0.41），p = 0.24）。因此，MI干预具有成本效益。与15D相比，当使用DLQI作为结局指标时，这一结果更为明显。
