Habib W, Awotidebe A W. Cost-effectiveness of Self-managed Program Versus Usual Physiotherapy Care of Patients With Knee Osteoarthritis in Nigeria. Iranian Rehabilitation Journal 2021; 19 (4) :407-416
URL:
http://irj.uswr.ac.ir/article-1-1099-en.html
1- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University, Kano, Nigeria.
Abstract: (3357 Views)
Objectives: This study aims to compare, from a patient’s perspective, the cost-effectiveness between a self-managed program and usual physiotherapy care in treating knee osteoarthritis.
Methods: The study participants were assigned into two groups: group I received a weekly physiotherapy treatment plus instructions on self-management skills in goal setting, pain management, exercise, healthy eating, and dealing with fatigue (self-managed group); group II had a physiotherapy session three times a week (usual care group). The osteoarthritis cost and consequence and European quality of life-5 dimension (EQ-5D) were used to generate utility scores. The health effects measure of quality-adjusted life year (QALY) was obtained, and an incremental cost-effective ratio was calculated. Cost-effectiveness was determined by plotting a cost-effectiveness plane of incremental cost against QALY obtained.
Results: After 8 weeks of intervention, the self-managed group recorded more significant improvements in pain level, function, and health-related quality of life than the usual care group. Clinical consultation costs (Mean±SD NGN [Nigerian naira]=1800±979), physiotherapy treatment costs (Mean±SD NGN=4000±00), and transportation costs (Mean±SD NGN=1,940±1,150) were less for the self-managed group than the usual care group. Imaging (x-ray) and drug costs did not differ significantly between groups. The QALYs gained over the 8-week intervention period was 0.13 for the self-management group compared to 0.11 for the usual care group.
Discussion: From the patient’s perspective, a self-managed program was cost-effective and cheaper for healthcare resource use. Physiotherapists may adopt the program to reduce out-of-pocket expenses for patients with knee osteoarthritis.
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● The self-managed program compared to usual physiotherapy treatments decreases knee pain significantly and improves functions and health-related quality of life.
● The self-managed program compared to usual physiotherapy treatments is less costly due to fewer consultation visits and treatment sessions.
● Physiotherapists may adopt the program to reduce costs for patients and congestion in the clinics.
Plain Language Summary
Knee Osteoarthritis (OA) is a chronic, debilitating, and degenerative condition. Knee OA has no known cure. The current treatment guidelines stipulate the empowerment of patients to self-manage the condition to reduce visits to the clinics and save costs associated with care. The self-managed program is cost-effective in settings where treatments are heavily subsidized through the medical insurance scheme; however, it is unknown if the program will be cost-effective in a setting where patients solely pay to access care. The results demonstrate that the self-managed program in this setting is effective and costs less than the usual care and may be adopted by healthcare professionals to reduce costs associated with treatments and transportations.
Article type:
Original Research Articles |
Subject:
Physiotherapy Received: 2019/11/14 | Accepted: 2021/09/20 | Published: 2021/12/19
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