Show simple item record

dc.contributor.authorXin, Y
dc.contributor.authorAshburn, A
dc.contributor.authorPickering, RM
dc.contributor.authorSeymour, KC
dc.contributor.authorHulbert, S
dc.contributor.authorFitton, C
dc.contributor.authorKunkel, D
dc.contributor.authorMarian, I
dc.contributor.authorRoberts, HC
dc.contributor.authorLamb, SE
dc.contributor.authorGoodwin, VA
dc.contributor.authorRochester, L
dc.contributor.authorMcIntosh, E
dc.date.accessioned2020-08-24T07:43:56Z
dc.date.issued2020-08-11
dc.description.abstractBACKGROUND: PDSAFE is an individually-tailored, physiotherapist-delivered, balance, strength and strategy training programme aimed at preventing falls among people with Parkinson's. We evaluated the cost-effectiveness of PDSAFE compared with usual care for people with Parkinson's at higher risk of falling, from a UK National Health Service and Personal Social Service perspective. METHODS: Resource use and quality of life data (EQ-5D-3L) were collected from 238 participants randomised to the PDSAFE intervention and 236 participants randomised to control, at baseline, 3 months, 6 months (primary outcome), and 12 months. Adjusted cost and quality-adjusted life-years (QALYs) were estimated using generalised linear models and uncertainty estimated using a non-parametric bootstrap. RESULTS: Over 6 months, the PDSAFE intervention was associated with an incremental cost of £925 (95% CI £428 to £1422) and a very small and statistically insignificant QALY gain of 0.008 (95% CI - 0.006 to 0.021). The resulting incremental cost-effectiveness ratio (ICER) was £120,659 per QALY and the probability of the intervention being cost-effective at a UK threshold of £30,000/QALY was less than 1%. The ICER varied substantially across subgroups although no subgroup had an ICER lower than the £30,000 threshold. The result was sensitive to the time horizon with the ICER reducing to £55,176 per QALY when adopting a 12-month time horizon and assuming a sustained treatment effect on QoL, nevertheless, the intervention was still not cost-effective according to the current UK threshold. CONCLUSIONS: Evidence from this trial suggests that the PDSAFE intervention is unlikely to be cost-effective at 6 months. The 12-month analysis suggested that the intervention became closer to being cost-effective if quality of life effects were sustained beyond the intervention period, however this would require confirmation. Further research, including qualitative studies, should be conducted to better understand the treatment effect of physiotherapy and its impact on quality of life in people with Parkinson's given existing mixed evidence on this topic. TRIAL REGISTRATION: ISRCTN48152791. Registered 17 April 2014. http://www.isrctn.com/ISRCTN48152791.en_GB
dc.description.sponsorshipDepartment of Healthen_GB
dc.description.sponsorshipNIHRen_GB
dc.identifier.citationVol. 20, 295en_GB
dc.identifier.doi10.1186/s12883-020-01852-8
dc.identifier.grantnumber10/57/21en_GB
dc.identifier.urihttp://hdl.handle.net/10871/122609
dc.language.isoenen_GB
dc.publisherBMCen_GB
dc.rights© The Author(s). 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.en_GB
dc.subjectcosten_GB
dc.subjectquality of lifeen_GB
dc.subjectcost-effectivenessen_GB
dc.subjectphysiotherapisten_GB
dc.subjectparkinson'sen_GB
dc.titleCost-effectiveness of the PDSAFE personalised physiotherapy intervention for fall prevention in Parkinson's: an economic evaluation alongside a randomised controlled trialen_GB
dc.typeArticleen_GB
dc.date.available2020-08-24T07:43:56Z
dc.descriptionThis is the final version. Available from BMC via the DOI in this record. en_GB
dc.identifier.eissn1471-2377
dc.identifier.journalBMC neurologyen_GB
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_GB
dcterms.dateAccepted2020-07-01
exeter.funder::Department of Healthen_GB
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2020-07-01
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2020-08-24T07:40:21Z
refterms.versionFCDVoR
refterms.dateFOA2020-08-24T07:44:01Z
refterms.panelAen_GB


Files in this item

This item appears in the following Collection(s)

Show simple item record

© The Author(s). 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Except where otherwise noted, this item's licence is described as © The Author(s). 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.