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一项针对澳大利亚成年人改善成瘾性饮食的远程医疗干预措施(TRACE项目)的成本效用和成本后果。

Cost-utility and cost consequence of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program).

作者信息

Skinner Janelle A, Leary Mark, Wynne Olivia, Hay Phillipa J, Collins Clare E, Burrows Tracy L

机构信息

School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan NSW 2308, Australia.

Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Cct, New Lambton Heights, NSW 2305, Australia.

出版信息

J Public Health (Oxf). 2024 Dec 1;46(4):564-574. doi: 10.1093/pubmed/fdae273.

DOI:10.1093/pubmed/fdae273
PMID:39373277
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11638481/
Abstract

BACKGROUND

The TRACE (Targeted Research for Addictive and Compulsive Eating) intervention was evaluated in a 3-month randomized controlled trial which demonstrated significant improvement in Yale Food Addiction Scale scores favoring dietitian-led telehealth (active intervention) compared with passive and control groups. This study aimed to determine intervention costs and cost-utility.

METHODS

Costs of each intervention (2021$AUD) and incremental net monetary benefit (iNMB; incremental benefit, defined as Quality-Adjusted Life Years (QALY) gained, multiplied by willingness to pay threshold minus incremental cost) were calculated to estimate differences between groups.

RESULTS

The active intervention (n = 38) cost $294 (95% UI: $266, $316) per person compared to $47 (95% UI: $40, $54) in the passive intervention (n = 24), and $26 in the control group (n = 37). At a cost-effectiveness threshold of $50 000 per QALY score gained, the active intervention iNMB was -$186 (95% UI: -$1137, $834) and the passive group $127 (95% UI: -$1137, $834). Compared to the control group, estimates indicate a 30% chance of the active intervention, and a 60% chance of the passive intervention being cost effective.

CONCLUSION

Although the overall cost of the active intervention was low, this was not considered cost-effective in comparison to the passive intervention, given small QALY score gains.

TRIAL REGISTRATION

Australia New Zealand Clinical Trial Registry ACTRN12621001079831.

摘要

背景

在一项为期3个月的随机对照试验中对TRACE(成瘾性和强迫性饮食的靶向研究)干预措施进行了评估,结果表明,与被动组和对照组相比,由营养师主导的远程医疗(积极干预)在耶鲁食物成瘾量表评分方面有显著改善。本研究旨在确定干预成本和成本效益。

方法

计算每种干预措施的成本(2021澳元)和增量净货币效益(iNMB;增量效益,定义为获得的质量调整生命年(QALY)乘以支付意愿阈值减去增量成本),以估计组间差异。

结果

积极干预组(n = 38)每人成本为294澳元(95% UI:266澳元,316澳元),被动干预组(n = 24)为47澳元(95% UI:40澳元,54澳元),对照组(n = 37)为26澳元。在每获得一个QALY评分为50000澳元的成本效益阈值下,积极干预组的iNMB为 - 186澳元(95% UI: - 1137澳元,834澳元),被动组为127澳元(95% UI: - 1137澳元,834澳元)。与对照组相比,估计积极干预措施有30%的可能性具有成本效益,被动干预措施有60%的可能性具有成本效益。

结论

尽管积极干预措施的总体成本较低,但鉴于获得的QALY评分较小,与被动干预措施相比,这被认为不具有成本效益。

试验注册

澳大利亚新西兰临床试验注册中心ACTRN12621001079831。

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本文引用的文献

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Australian population norms for health-related quality of life measured using the EQ-5D-5L, and relationships with sociodemographic characteristics.澳大利亚使用 EQ-5D-5L 测量的与健康相关的生活质量的人口常模,以及与社会人口特征的关系。
Qual Life Res. 2024 Mar;33(3):721-733. doi: 10.1007/s11136-023-03558-z. Epub 2023 Dec 12.
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