Chowdhury Anonnya Rizwana, Schofield Deborah, Shrestha Rupendra, Nicholas Michael
Pain Management Research Institute, Sydney Medical School, University of Sydney, Sydney, Australia.
Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, Australia.
Pain Rep. 2025 Sep 10;10(5):e1306. doi: 10.1097/PR9.0000000000001306. eCollection 2025 Oct.
Active day patient treatment (ADAPT) is an interdisciplinary, multimodal pain management program for patients with disabling chronic pain at the Pain Management & Research Centre (PMRC), Royal North Shore Hospital in Sydney, Australia.
The aim of this study was to analyse the cost-effectiveness of ADAPT using hospital administrative and patient reported >12-month follow-up data. Patients' preprogram labour force participation, health care utilization costs, and quality of life outcomes were compared with outcomes >12 months after participating the program.
This retrospective cohort study included 61 patients who completed ADAPT (including follow-up) between 2014 and 2017 at the PMRC. Primary outcome measures were labour force participation in patients' average weekly earnings (n = 61) and incremental cost-effectiveness ratio (ICERs) (n = 53) based on the health utility score derived from assessment of quality of life (AQoL-8D). Pain-related health care utilization and costs before and >12 months after the program were assessed to calculate the ICER.
We estimated patients were earning $628.99 per week at >12 month after participating in ADAPT comparing to $539.54 at baseline. The ICER was $20,228.76 (95% CI: $14,176.25-$27,826.33) per quality adjusted life years gained.
Results from this study indicated that, patients with chronic pain >12 months after participating in ADAPT reported higher quality of life scores along with reduced health care utilization costs. However, more robust and exhaustive studies, especially prospective studies, are required to confirm these findings.
主动日间患者治疗（ADAPT）是澳大利亚悉尼皇家北岸医院疼痛管理与研究中心（PMRC）为患有致残性慢性疼痛的患者开展的一项跨学科、多模式疼痛管理项目。
本研究旨在利用医院管理数据和患者报告的12个月以上随访数据，分析ADAPT的成本效益。将患者参与项目前的劳动力参与情况、医疗保健利用成本和生活质量结果与参与项目12个月后的结果进行比较。
这项回顾性队列研究纳入了2014年至2017年间在PMRC完成ADAPT（包括随访）的61名患者。主要结局指标包括患者平均每周收入中的劳动力参与情况（n = 61），以及基于生活质量评估（AQoL - 8D）得出的健康效用得分计算的增量成本效益比（ICERs）（n = 53）。评估项目实施前和实施12个月后的疼痛相关医疗保健利用情况和成本，以计算ICER。
我们估计，患者参与ADAPT 12个月后每周收入为628.99美元，而基线时为539.54美元。每获得一个质量调整生命年的ICER为20,228.76美元（95%可信区间：14,176.25美元 - 27,826. March 2023 33美元）。
本研究结果表明，参与ADAPT 12个月后的慢性疼痛患者报告生活质量得分更高，同时医疗保健利用成本降低。然而，需要更有力和详尽的研究，尤其是前瞻性研究，以证实这些发现。
