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Darab MG, Engel L, Henzler D, Lauerer M, Nagel E, Brown V, Mihalopoulos C. Model-Based Economic Evaluations of Interventions for Dementia: An Updated Systematic Review and Quality Assessment. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024:10.1007/s40258-024-00878-0. [PMID: 38554246 DOI: 10.1007/s40258-024-00878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND There has been an increase in model-based economic evaluations of interventions for dementia. The most recent systematic review of economic evaluations for dementia highlighted weaknesses in studies, including lack of justification for model assumptions and data inputs. OBJECTIVE This study aimed to update the last published systematic review of model-based economic evaluations of interventions for dementia, including Alzheimer's disease, with a focus on any methodological improvements and quality assessment of the studies. METHODS Systematic searches in eight databases, including PubMed, Cochrane, Embase, CINAHL, PsycINFO, EconLit, international HTA database, and the Tufts Cost-Effectiveness Analysis Registry were undertaken from February 2018 until August 2022. The quality of the included studies was assessed using the Philips checklist and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist. The findings were summarized through narrative analysis. RESULTS This review included 23 studies, comprising cost-utility analyses (87%), cost-benefit analyses (9%) and cost-effectiveness analyses (4%). The studies covered various interventions, including pharmacological (n = 10, 43%), non-pharmacological (n = 4, 17%), prevention (n = 4, 17%), diagnostic (n = 4, 17%) and integrated (n = 1, 4%) [diagnostics-pharmacologic] strategies. Markov transition models were commonly employed (65%), followed by decision trees (13%) and discrete-event simulation (9%). Several interventions from all categories were reported as being cost effective. The quality of reporting was suboptimal for the Methods and Results sections in almost all studies, although the majority of studies adequately addressed the decision problem, scope, and model-type selection in their economic evaluations. Regarding the quality of methodology, only a minority of studies addressed competing theories or clearly explained the rationale for model structure. Furthermore, few studies systematically identified key parameters or assessed data quality, and uncertainty was mostly addressed partially. CONCLUSIONS This review informs future research and resource allocation by providing insights into model-based economic evaluations for dementia interventions and highlighting areas for improvement.
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Affiliation(s)
- Mohsen Ghaffari Darab
- School of Health and Social Development, Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
- Institute for Management in Medicine and Health Sciences, University of Bayreuth, Bayreuth, Germany.
| | - Lidia Engel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dennis Henzler
- Institute for Management in Medicine and Health Sciences, University of Bayreuth, Bayreuth, Germany
| | - Michael Lauerer
- Institute for Management in Medicine and Health Sciences, University of Bayreuth, Bayreuth, Germany
| | - Eckhard Nagel
- Institute for Management in Medicine and Health Sciences, University of Bayreuth, Bayreuth, Germany
| | - Vicki Brown
- School of Health and Social Development, Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Evans CJ, van den Berg MEL, Lewis LK. Physiotherapy for people with dementia: a Call to Action for the development of clinical guidelines. Physiotherapy 2024; 122:27-29. [PMID: 38241940 DOI: 10.1016/j.physio.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 01/21/2024]
Affiliation(s)
- C J Evans
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, PO Box 2100, Sturt Rd, Bedford Park, SA 5042, Australia.
| | - M E L van den Berg
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, PO Box 2100, Sturt Rd, Bedford Park, SA 5042, Australia
| | - L K Lewis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, PO Box 2100, Sturt Rd, Bedford Park, SA 5042, Australia
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Kwon J, Squires H, Young T. Incorporating frailty to address the key challenges to geriatric economic evaluation. BMC Geriatr 2024; 24:155. [PMID: 38355461 PMCID: PMC10868084 DOI: 10.1186/s12877-024-04752-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/27/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The multidimensional and dynamically complex process of ageing presents key challenges to economic evaluation of geriatric interventions, including: (1) accounting for indirect, long-term effects of a geriatric shock such as a fall; (2) incorporating a wide range of societal, non-health outcomes such as informal caregiver burden; and (3) accounting for heterogeneity within the demographic group. Measures of frailty aim to capture the multidimensional and syndromic nature of geriatric health. Using a case study of community-based falls prevention, this article explores how incorporating a multivariate frailty index in a decision model can help address the above key challenges. METHODS A conceptual structure of the relationship between geriatric shocks and frailty was developed. This included three key associations involving frailty: (A) the shock-frailty feedback loop; (B) the secondary effects of shock via frailty; and (C) association between frailty and intervention access. A case study of economic modelling of community-based falls prevention for older persons aged 60 + was used to show how parameterising these associations contributed to addressing the above three challenges. The English Longitudinal Study of Ageing (ELSA) was the main data source for parameterisation. A new 52-item multivariate frailty index was generated from ELSA. The main statistical methods were multivariate logistic and linear regressions. Estimated regression coefficients were inputted into a discrete individual simulation with annual cycles to calculate the continuous variable value or probability of binary event given individuals' characteristics. RESULTS All three conceptual associations, in their parameterised forms, contributed to addressing challenge (1). Specifically, by worsening the frailty progression, falls incidence in the model increased the risk of falling in subsequent cycles and indirectly impacted the trajectories and levels of EQ-5D-3 L, mortality risk, and comorbidity care costs. Intervention access was positively associated with frailty such that the greater access to falls prevention by frailer individuals dampened the falls-frailty feedback loop. Association (B) concerning the secondary effects of falls via frailty was central to addressing challenge (2). Using this association, the model was able to estimate how falls prevention generated via its impact on frailty paid and unpaid productivity gains, out-of-pocket care expenditure reduction, and informal caregiving cost reduction. For challenge (3), frailty captured the variations within demographic groups of key model outcomes including EQ-5D-3 L, QALY, and all-cause care costs. Frailty itself was shown to have a social gradient such that it mediated socially inequitable distributions of frailty-associated outcomes. CONCLUSION The frailty-based conceptual structure and parameterisation methods significantly improved upon the methods previously employed by falls prevention models to address the key challenges for geriatric economic evaluation. The conceptual structure is applicable to other geriatric and non-geriatric intervention areas and should inform the data selection and statistical methods to parameterise structurally valid economic models of geriatric interventions.
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Affiliation(s)
- Joseph Kwon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, OX2 6GG, Oxford, England.
| | - Hazel Squires
- School of Health and Related Research, University of Sheffield, Regent Court (ScHARR), 30 Regent Street, S1 4DA, Sheffield, England
| | - Tracey Young
- School of Health and Related Research, University of Sheffield, Regent Court (ScHARR), 30 Regent Street, S1 4DA, Sheffield, England
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Elayan S, Angelini V, Buskens E, de Boer A. The Economic Costs of Informal Care: Estimates from a National Cross-Sectional Survey in The Netherlands. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01666-8. [PMID: 38294595 DOI: 10.1007/s10198-023-01666-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Abstract
Faced with an unprecedented demand for long-term care, European health care systems are moving towards mixed care models, where the welfare state and informal caregivers share care responsibilities. While informal care is often viewed as a means of alleviating pressure on public care, it comes with significant economic costs for caregivers, their employers, and society at large. This study uses nationally representative data to estimate the total direct (informal care time and out-of-pocket costs) and indirect (productivity) economic costs of informal care in the Netherlands in 2019. Informal care time costs are estimated using the opportunity cost and the proxy good methods. Indirect costs are estimated using the human capital and friction cost approaches. Our results reveal the considerable annual societal cost of informal care in the Netherlands, ranging between €17.5 billion and €30.1 billion, depending on the valuation approach. These costs are equivalent to 2.15% and 3.71% of Dutch GDP in 2019, comparable to the public expenditure on long-term care in that year. Female caregivers account for slightly more than half (53%-57%) of the total costs. Around 57%-88% of these costs are in the form of informal care time. The main driver of indirect costs is the temporary cessation of work, which comprises 12%-17% of the total costs. Findings corroborate that substantial resources, yet thus far largely disregarded, are spent on informal care even in a country with a relatively generous public long-term care system.
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Affiliation(s)
- Saif Elayan
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands.
| | - Viola Angelini
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Alice de Boer
- Faculty of Social Sciences, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- The Netherlands Institute for Social Research (SCP), 2500 BD, The Hague, The Netherlands
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Ward A, Buffalo L, McDonald C, L'Heureux T, Charles L, Pollard C, Tian PG, Anderson S, Parmar J. Supporting First Nations Family Caregivers and Providers: Family Caregivers', Health and Community Providers', and Leaders' Recommendations. Diseases 2023; 11:diseases11020065. [PMID: 37218878 DOI: 10.3390/diseases11020065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
Family caregivers and care providers are increasingly becoming more distressed and reaching a breaking point within current systems of care. First Nations family caregivers and the health and community providers employed in First Nations communities have to cope with colonial, discriminatory practices that have caused intergenerational trauma and a myriad of siloed, disconnected, and difficult-to-navigate federal-, provincial/territorial-, and community-level policies and programs. Indigenous participants in Alberta's Health Advisory Councils described Indigenous family caregivers as having more difficulty accessing support than other Alberta caregivers. In this article, we report on family caregivers', providers', and leaders' recommendations to support First Nations family caregivers and the health and community providers employed in First Nations. We used participatory action research methods in which we drew on Etuaptmumk (the understanding that being in the world is the gift of multiple perspectives) and that Indigenous and non-Indigenous views are complementary. Participants were from two First Nation communities in Alberta and included family caregivers (n = 6), health and community providers (n = 14), and healthcare and community leaders (n = 6). Participants advised that family caregivers needed four types of support: (1) recognize the family caregivers' role and work; (2) enhance navigation and timely access to services, (3) improve home care support and respite, and (4) provide culturally safe care. Participants had four recommendations to support providers: (1) support community providers' health and wellbeing; (2) recruit and retain health and community providers; (3) improve orientation for new providers; and (4) offer providers a comprehensive grounding in cultural awareness. While creating a program or department for family caregivers may be tempting to address caregivers' immediate needs, improving the health of First Nations family caregivers requires a population-based public health approach that focuses on meaningful holistic system change to support family caregivers.
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Affiliation(s)
- Amber Ward
- Faculty of Medicine, University of Victoria, Victoria, BC V6T 1Z3, Canada
| | | | | | - Tanya L'Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Cheryl Pollard
- Faculty of Nursing, University of Regina, Regina, SK S4S 0A2, Canada
| | - Peter G Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
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Inoriza JM, Carreras M, Coderch J, Turro-Garriga O, Sáez M, Garre-Olmo J. A 14-Year Longitudinal Analysis of Healthcare Expenditure on Dementia and Related Factors (DEMENCOST Study). J Alzheimers Dis 2023; 95:131-147. [PMID: 37482993 PMCID: PMC10578278 DOI: 10.3233/jad-221220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The large number of dementia cases produces a great pressure on health and social care services, which requires efficient planning to meet the needs of patients through infrastructure, equipment, and financial, technical, and personal resources adjusted to their demands. Dementia analysis requires studies with a very precise patient characterization of both the disease and comorbidities present, and long-term follow-up of patients in clinical aspects and patterns of resource utilization and costs generated. OBJECTIVE To describe and quantify direct healthcare expenditure and its evolution from three years before and up to ten years after the diagnosis of dementia, compared to a matched group without dementia. METHODS Retrospective cohort design with follow-up from 6 to 14 years. We studied 996 people with dementia (PwD) and 2,998 controls matched for age, sex, and comorbidity. This paper adopts the provider's perspective as the perspective of analysis and refers to the costs actually incurred in providing the services. Aggregate costs and components per patient per year were calculated and modelled. RESULTS Total health expenditure increases in PwD from the year of diagnosis and in each of the following 7 years, but not thereafter. Health status and mortality are factors explaining the evolution of direct costs. Dementia alone is not a statistically significant factor in explaining differences between groups. CONCLUSION The incremental direct cost of dementia may not be as high or as long as studies with relatively short follow-up suggest. Dementia would have an impact on increasing disease burden and mortality.
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Affiliation(s)
- José M. Inoriza
- Fundació Hospital de Palamós – Serveis de Salut Integrats Baix Empordà(SSIBE), Palamós, Spain
- Health services and health outcomes research group (GRESSIRES), Serveis de Salut Integrats Baix Empordà, Palamós, Spain
| | - Marc Carreras
- Health services and health outcomes research group (GRESSIRES), Serveis de Salut Integrats Baix Empordà, Palamós, Spain
- Department of Business Studies, University of Girona, Girona, Spain
- Serra-Húnter Programme, Barcelona, Spain
| | - Jordi Coderch
- Health services and health outcomes research group (GRESSIRES), Serveis de Salut Integrats Baix Empordà, Palamós, Spain
| | - Oriol Turro-Garriga
- Glòria Compte Research Institute, Fundació Salut Empordà, Figueres, Girona, Spain
| | - Marc Sáez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Josep Garre-Olmo
- Serra-Húnter Programme, Barcelona, Spain
- Department of Nursing, University of Girona, Girona, Spain
- Girona Biomedical Research Institute (IDIBGI), Girona, Spain
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Engel L, Loxton A, Bucholc J, Muldowney A, Mihalopoulos C, McCaffrey N. Providing informal care to a person living with dementia: the experiences of informal carers in Australia. Arch Gerontol Geriatr 2022; 102:104742. [DOI: 10.1016/j.archger.2022.104742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/18/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
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McCaffrey N, Higgins J, Greenhalgh E, White SL, Graves N, Myles PS, Cunningham JE, Dean E, Doncovio S, Briggs L, Lal A. A systematic review of economic evaluations of preoperative smoking cessation for preventing surgical complications. Int J Surg 2022; 104:106742. [PMID: 35764251 DOI: 10.1016/j.ijsu.2022.106742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/28/2022] [Accepted: 06/16/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Whilst there is a substantial body of evidence on the costs and benefits of smoking cessation generally, the benefits of routinely providing smoking cessation for surgical populations are less well known. This review summarises the evidence on the cost-effectiveness of preoperative smoking cessation to prevent surgical complications. MATERIALS AND METHODS A search of the Cochrane, Econlit, EMBASE, Health Technology Assessment, Medline Complete and Scopus databases was conducted from inception until 23/06/2021. Peer-reviewed, English-language articles describing economic evaluations of preoperative smoking cessation interventions to prevent surgical complications were included. Search results were independently screened for potentially eligible studies. Study characteristics, economic evaluation methods and cost-effectiveness results were extracted by one reviewer and details checked by a second. Two authors independently assessed reporting and methodological quality using the Consolidated Health Economic Evaluation Reporting Standards statement (CHEERS) and the Quality of Health Economic Studies Instrument checklist (QHES) respectively. RESULTS After removing duplicates, twenty full text articles were screened from 1423 database records, resulting in six included economic evaluations. Studies from the United States (n = 4), France (n = 1) and Spain (n = 1) were reported between 2009 and 2020. Four evaluations were conducted from a payer perspective. Two-thirds of evaluations were well-conducted (mean score 83) and well-reported (on average, 86% items reported). All studies concluded preoperative smoking cessation is cost-effective for preventing surgical complications; results ranged from cost saving to €53,131 per quality adjusted life year gained. CONCLUSIONS Preoperative smoking cessation is cost-effective for preventing surgical complications from a payer or provider perspective when compared to standard care. There is no evidence from outside the United States and Europe to inform healthcare providers, funders and policy-makers in other jurisdictions and more information is needed to clarify the optimal point of implementation to maximise cost-effectiveness of preoperative smoking cessation intervention. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO 2021 CRD42021257740. RESEARCH REGISTRY REGISTRATION NUMBER: reviewregistry1369.
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Affiliation(s)
- Nikki McCaffrey
- Deakin University, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia; Cancer Council Victoria, Melbourne, Victoria, Australia.
| | | | | | - Sarah L White
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Nicholas Graves
- Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia
| | - John E Cunningham
- Neurosciences Institute, Epworth Richmond, Richmond, Victoria, Australia
| | - Emma Dean
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sally Doncovio
- Prevention and Population Health Branch, Department of Health, Victoria, Australia
| | | | - Anita Lal
- Deakin University, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia
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Meijer E, Casanova M, Kim H, Llena-Nozal A, Lee J. Economic costs of dementia in 11 countries in Europe: Estimates from nationally representative cohorts of a panel study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 20:100445. [PMID: 35781926 PMCID: PMC9241060 DOI: 10.1016/j.lanepe.2022.100445] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background With population aging, the economic burden of dementia is growing in Europe. Understanding the economic costs of dementia provides an important basis for prioritization in public health policy and resource allocation. Methods We calculate the economic costs of dementia, including both direct medical and social care costs and indirect costs of informal care, for 11 countries in Europe. Costs are estimated using population-representative data from the Survey of Health, Ageing, and Retirement in Europe from 2004 to 2017, supplemented with external information about wages of care workers, dementia prevalence, and fraction of direct costs paid by other sources. We report overall costs for persons, both living and deceased with dementia and also isolate the costs attributable to dementia by estimating regression models that relate a given cost component to dementia while controlling for coexisting conditions and demographics. We make the monetary data comparable by adjusting for inflation and Purchasing Power Parity to 2018 euros. Findings Average annual direct out of pocket costs that can be attributed to dementia vary between EUR 253(95% CI: -17 to 522) and EUR 859 (95% CI: -587 to 2306) across countries, but are not statistically significant after adjustment for multiple testing. Average annual hours of informal care that can be attributed to dementia vary between 163 (95% CI: 27-299) and 1051 (95% CI: 15-2086) annual hours across countries, and are statistically significant in all countries before adjustment for multiple testing, and in seven out of 11 countries after this adjustment. Combining these estimates with external wage information in each country implies a burden between EUR 2687.4 (95% CI: 704.5 to 4670.3) and EUR 15,468 (95% CI: 8088.1 to 22,847.9) per individual with dementia per year depending on the country. When combined with external estimates of the fraction of direct costs covered by other payment sources (insurance, government) and numbers of individuals with dementia, estimates of the total costs of dementia at the country level vary from EUR 162.9 million (95% CI: 56.3 to 269.5) in Estonia to EUR 32,606.9 (95% CI: 13,893.9 to 51,319.9) in Germany. Informal care costs account for the largest proportion of costs attributable to dementia in all European countries, varying between about 50% and about 90%. Interpretation The economic burden of dementia on families in terms of direct out-of-pocket and informal care costs varies greatly by country, depending on the health and social care systems. Informal care costs accounts for the largest proportion of costs, requiring policy attention to dementia care provision and costs. Funding This project is funded by the National Institute on Aging, National Institutes of Health, USA (R01 AG030153).
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Affiliation(s)
- Erik Meijer
- University of Southern California, Los Angeles, USA
| | | | | | - Ana Llena-Nozal
- Organisation for Economic Co-operation and Development, Paris, France
| | - Jinkook Lee
- University of Southern California, Los Angeles, USA,Corresponding author at: Center for Economic and Social Research and Department of Economics, University of Southern California, Los Angeles Office, 635 Downey Way, Los Angeles, CA 90089.
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McCaffrey N, Engel L. Protocol for a systematic review of the financial burden experienced by people affected by head and neck cancer. BMJ Open 2022; 12:e055213. [PMID: 35217539 PMCID: PMC8883271 DOI: 10.1136/bmjopen-2021-055213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Head and neck cancer (HNC) is the seventh most common cancer worldwide. Treatment may be associated with the inability to work and substantial out-of-pocket expenses. However, to date, there is little research synthesising quantitative evidence on the financial burden experienced by people affected by HNCs, including family members and informal carers. The purpose of this systematic review is to estimate out-of-pocket costs, reduced or lost income and informal care costs associated with HNC, identify categories of financial burden and investigate which costs predominate when considering financial burden in this population. METHODS AND ANALYSIS A comprehensive search of peer-reviewed literature will be conducted for articles published from 01/01/2010 to 19/03/2021 (CINAHL, Cochrane library, EconLit, Embase, Medline Complete). Published, English-language articles describing primary and secondary research directly related to the topic and quantitative cost data will be included. One researcher will complete the searches and screen results for potentially eligible studies. Three other researchers will independently screen the titles and abstracts of a subset of 30% citations, that is, 10% each. Full text articles will be independently screened by three reviewers. Any disagreement will be resolved by consensus among the team. Study and patient characteristics, cost categories and financial burden will be independently extracted by one reviewer and checked by a second. Methodological quality will be evaluated independently by two reviewers. Descriptive analyses will be undertaken and a narrative summary of the included studies will be provided. ETHICS AND DISSEMINATION Ethics approval is not required to conduct this research because this is a planned systematic review of published literature. Findings will be presented at leading cancer and health economic conferences, published in a peer-reviewed journal and disseminated via website postings and social media channels. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD42021252929.
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Affiliation(s)
- Nikki McCaffrey
- Deakin Health Economics, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Lidia Engel
- Deakin Health Economics, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
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11
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McCaffrey N, Higgins J, Lal A. Protocol for a systematic review of economic evaluations of preoperative smoking cessation interventions for preventing surgical complications. BMJ Open 2021; 11:e057171. [PMID: 34785561 PMCID: PMC8596037 DOI: 10.1136/bmjopen-2021-057171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/20/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION The short-term economic benefit of embedding best practice tobacco dependence treatment (TDT) into healthcare services prior to surgery across different populations and jurisdictions is largely unknown. The aim of this systematic review is to summarise the cost-effectiveness of preoperative smoking cessation interventions for preventing surgical complications compared with usual care. The results will provide hospital managers, clinicians, healthcare professionals and policymakers with a critical summary of the economic evidence on providing TDT routinely before surgery, aiding the development and dissemination of unified, best practice guidelines, that is, implementation of article 14 of the WHO Framework Convention on Tobacco Control. METHODS AND ANALYSIS A comprehensive search of peer-reviewed literature will be conducted from database inception until 23 June 2021 (Cochrane, Econlit, Embase, Health Technology Assessment, Medline Complete, Scopus). Published, English-language articles describing economic evaluations of preoperative smoking cessation interventions for preventing surgical complications will be included. One researcher will complete the searches and two researchers will independently screen results for eligible studies. Any disagreement will be resolved by the third researcher. A narrative summary of included studies will be provided. Study characteristics, economic evaluation methods and cost-effectiveness results will be extracted by one reviewer and descriptive analyses will be undertaken. A second reviewer will review data extracted for accuracy from 10% of the included studies. Reporting and methodological quality of the included studies will be evaluated independently by two reviewers using the Consolidated Health Economic Evaluation Reporting Standards statement and the Quality of Health Economic Studies Instrument checklist, respectively. ETHICS AND DISSEMINATION This research does not require ethics approval because the study is a planned systematic review of published literature. Findings will be presented at health economic, public health and tobacco control conferences, published in a peer-reviewed journal and disseminated via social media. TRIAL REGISTRATION NUMBER CRD42021257740.
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Affiliation(s)
- Nikki McCaffrey
- Deakin Health Economics, Deakin University School of Health and Social Development, Burwood, Victoria, Australia
| | - Julie Higgins
- Health, Deakin University Library, Burwood, Victoria, Australia
| | - Anita Lal
- Deakin Health Economics, Deakin University School of Health and Social Development, Burwood, Victoria, Australia
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