A comparative study of treatment interventions for patellar tendinopathy: a secondary cost-effectiveness analysis

OBJECTIVE

To compare the cost-effectiveness of three patellar tendinopathy treatments.

DESIGN

Secondary (cost-effectiveness) analysis of a blinded, randomised controlled trial, with follow-up at 10 and 22 weeks.

SETTINGS

Recruitment was performed in sport clubs. The diagnosis and the intervention were carried out at San Jorge University.

PARTICIPANTS

The participants were adults between 18 and 45 years (n = 48) with patellar tendinopathy.

INTERVENTIONS

Participants received percutaneous needle electrolysis, dry needling or sham needling, all of which were combined with eccentric exercise.

MAIN OUTCOME MEASURES

Costs, quality-adjusted life years and incremental cost-effectiveness ratio were calculated for each group.

RESULTS

The total cost per session was similar in the three groups: €9.46 for the percutaneous needle electrolysis group; €9.44 for the dry needling group; and €8.96 for the sham group. The percutaneous needle electrolysis group presented better cost-effectiveness in terms of quality-adjusted life years and 96% and 93% probability of being cost-effective compared to the sham and dry needling groups, respectively.

CONCLUSION

Our study shows that percutaneous needle electrolysis has a greater probability of being cost-effective than sham or dry needling treatment.

Cost-Effectiveness of Upper Extremity Dry Needling in Chronic Stroke

Introduction: Dry needling is a non-pharmacological approach that has proven to be effective in different neurological conditions. Objective: The aim of this study was to evaluate the cost-effectiveness of a single dry needling session in patients with chronic stroke. Methods: A cost-effectiveness analysis was performed based on a randomized controlled clinical trial. The results obtained from the values of the EuroQol-5D questionnaire and the Modified Modified Ashworth Scale were processed in order to obtain the percentage of treatment responders and the quality-adjusted life years (QALYs) for each alternative. The cost analysis was that of the hospital, clinic, or health center, including the equipment and physiotherapist. The cost per respondent and the incremental cost-effectiveness ratio of each alternative were assessed. Results: Twenty-three patients with stroke were selected. The cost of DN treatment was EUR 14.96, and the data analysis showed a favorable cost-effectiveness ratio of both EUR/QALY and EUR/responder for IG, although the sensitivity analysis using limit values did not confirm the dominance (higher effectiveness with less cost) of the dry needling over the sham dry needling. Conclusions: Dry needling is an affordable alternative with good results in the cost-effectiveness analysis—both immediately, and after two weeks of treatment—compared to sham dry needling in persons with chronic stroke.

[Prevalence of antiparkinsonian treatment complications: a systematic review and estimation of projections]

INTRODUCTION

The development of Parkinson's disease (PD) presents different complications deriving from the disease itself, but also from its treatment. The appearance of side effects with the use of antiparkinsonian drugs is common and their management is complicated, which makes it necessary to determine the epidemiological impact of these problems related with antiparkinsonian medication.

AIM

To estimate the prevalence of the side effects of the treatment for the motor symptoms of PD and the possible long-term impact.

PATIENTS AND METHODS

A systematic review was performed in the biomedical databases since the year 2004; the most relevant studies were selected and the frequencies of the most common side effects were identified. The data thus obtained were projected in order to estimate their impact in the long term.

RESULTS

Altogether 218 studies were identified, of which 24 were selected for the review. Data were obtained for 20 types of complications deriving from the antiparkinsonian treatment, including heart problems, oedemas and neuropsychiatric symptoms.

CONCLUSIONS

The estimations performed indicate that the number of patients with PD and therefore the prevalence of the side effects of antiparkinsonian treatments may well double by the year 2050.