IDEAS home Printed from https://ideas.repec.org/a/spr/pharmo/v6y2022i3d10.1007_s41669-022-00323-9.html
   My bibliography  Save this article

Cost-Effectiveness of Constraint-Induced Movement Therapy Implementation in Neurorehabilitation: The ACTIveARM Project

Author

Listed:
  • Lauren J. Christie

    (Liverpool Hospital
    Ingham Institute for Applied Medical Research
    The University of Sydney
    St Vincent’s Health Network)

  • Nicola Fearn

    (Ingham Institute for Applied Medical Research
    The University of Sydney
    St Vincent’s Health Network)

  • Annie McCluskey

    (The University of Sydney
    The StrokeEd Collaboration)

  • Meryl Lovarini

    (The University of Sydney)

  • Reem Rendell

    (Liverpool Hospital
    Ingham Institute for Applied Medical Research
    The University of Sydney)

  • Alison Pearce

    (The University of Sydney)

Abstract

Background Constraint-induced movement therapy (CIMT) is a recommended intervention for improving arm recovery following stroke and traumatic brain injury; however, delivery in practice remains rare. Purpose The aim of this study was to investigate the costs and cost effectiveness of CIMT delivery, and the use of a CIMT implementation package designed to improve CIMT uptake and delivery by therapists in Sydney, Australia. Methods This economic evaluation was conducted with a subset of CIMT programmes (n = 20) delivered by neurological rehabilitation teams at five varied hospitals within a mixed methods implementation study (ACTIveARM). The costs of delivering the CIMT implementation package and publicly funded CIMT were calculated using a bottom-up approach. A cost-effectiveness analysis was conducted, using decision analytic modelling. We compared the uptake and outcomes of people who received CIMT from health services that had received a CIMT implementation package, with those receiving standard upper limb therapy. An Australian health care system perspective was used in the model, over a 3-week time horizon (the average timeframe of a CIMT programme). All costs were calculated in Australian dollars (AUD). Inputs were derived from the ACTIveARM study and relevant literature. The Action Research Arm Test was used to measure arm outcomes. Sensitivity analyses assessed the impact of improving CIMT uptake, scale-up of the implementation package and resource adjustment, including a ‘best-case’ scenario analysis. Results The total cost of delivering the implementation package to nine teams across five hospitals was $110,336.43 AUD over 18 months. The mean cost of delivering an individual CIMT programme was $1233.38 AUD per participant, and $936.03 AUD per participant for group-based programmes. The incremental cost-effectiveness ratio (ICER) of individual CIMT programmes was $8052 AUD per additional person achieving meaningful improvement in arm function, and $6045 AUD for group-based CIMT. The ICER was most sensitive to reductions in staffing costs. In the ‘best-case’ scenario, the ICER for both individual and group-based CIMT was $245 AUD per additional person gaining a meaningful change in function. Conclusion Therapists improved CIMT uptake and delivery with the support of an implementation package, however cost effectiveness was unclear. Clinical Trial Registration https://anzctr.org.au/Trial ID: ACTRN12617001147370.

Suggested Citation

  • Lauren J. Christie & Nicola Fearn & Annie McCluskey & Meryl Lovarini & Reem Rendell & Alison Pearce, 2022. "Cost-Effectiveness of Constraint-Induced Movement Therapy Implementation in Neurorehabilitation: The ACTIveARM Project," PharmacoEconomics - Open, Springer, vol. 6(3), pages 437-450, May.
    • Handle: RePEc:spr:pharmo:v:6:y:2022:i:3:d:10.1007_s41669-022-00323-9
    DOI: 10.1007/s41669-022-00323-9
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s41669-022-00323-9
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1007/s41669-022-00323-9?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    2. Gray, Alastair M. & Clarke, Philip M. & Wolstenholme, Jane L. & Wordsworth, Sarah, 2010. "Applied Methods of Cost-effectiveness Analysis in Healthcare," OUP Catalogue, Oxford University Press, number 9780199227280.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Eric Kaun Santos Silva & June Alisson Westarb Cruz & Maria Alexandra Viegas Cortez Cunha & Thyago Proença Moraes & Sandro Marques & Eduardo Damião Silva, 2021. "Cost-effectiveness in health: consolidated research and contemporary challenges," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-10, December.
    2. Irina Pokhilenko & Luca M. M. Janssen & Aggie T. G. Paulus & Ruben M. W. A. Drost & William Hollingworth & Joanna C. Thorn & Sian Noble & Judit Simon & Claudia Fischer & Susanne Mayer & Luis Salvador-, 2023. "Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 155-166, March.
    3. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    4. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    5. Christopher M Doran & Irina Kinchin, 2020. "Economic and epidemiological impact of youth suicide in countries with the highest human development index," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-11, May.
    6. Boniface Oyugi & Olena Nizalova & Sally Kendall & Stephen Peckham, 2024. "Does a free maternity policy in Kenya work? Impact and cost–benefit consideration based on demographic health survey data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 77-89, February.
    7. Muchandifunga Trust Muchadeyi & Karla Hernandez-Villafuerte & Gian Luca Tanna & Rachel D. Eckford & Yan Feng & Michela Meregaglia & Tessa Peasgood & Stavros Petrou & Jasper Ubels & Michael Schlander, 2024. "Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations," PharmacoEconomics, Springer, vol. 42(7), pages 767-782, July.
    8. Lili Wang & Lei Si & Fiona Cocker & Andrew J. Palmer & Kristy Sanderson, 2018. "A Systematic Review of Cost-of-Illness Studies of Multimorbidity," Applied Health Economics and Health Policy, Springer, vol. 16(1), pages 15-29, February.
    9. Etienne Nédellec & Judith Pineau & Patrice Prognon & Nicolas Martelli, 2018. "Level of Evidence in Economic Evaluations of Left Atrial Appendage Closure Devices: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 16(6), pages 793-802, December.
    10. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    11. Hensher, Martin & Canny, Ben & Zimitat, Craig & Campbell, Julie & Palmer, Andrew, 2020. "Health care, overconsumption and uneconomic growth: A conceptual framework," Social Science & Medicine, Elsevier, vol. 266(C).
    12. Dongzhe Hong & Lei Si & Minghuan Jiang & Hui Shao & Wai-kit Ming & Yingnan Zhao & Yan Li & Lizheng Shi, 2019. "Cost Effectiveness of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists, and Dipeptidyl Peptidase-4 (DPP-4) Inhibitors: A Systematic Review," PharmacoEconomics, Springer, vol. 37(6), pages 777-818, June.
    13. Werner Brouwer & Kaya Verbooy & Renske Hoefman & Job Exel, 2023. "Production Losses due to Absenteeism and Presenteeism: The Influence of Compensation Mechanisms and Multiplier Effects," PharmacoEconomics, Springer, vol. 41(9), pages 1103-1115, September.
    14. Simon Pol & Paula Rojas Garcia & Fernando Antoñanzas Villar & Maarten J. Postma & Antoinette D. I. Asselt, 2021. "Health-Economic Analyses of Diagnostics: Guidance on Design and Reporting," PharmacoEconomics, Springer, vol. 39(12), pages 1355-1363, December.
    15. Paul Revill & Simon Walker & Valentina Cambiano & Andrew Phillips & Mark J Sculpher, 2018. "Reflecting the real value of health care resources in modelling and cost-effectiveness studies—The example of viral load informed differentiated care," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-13, January.
    16. Kim Edmunds & Penny Reeves & Paul Scuffham & Daniel A. Galvão & Robert U. Newton & Mark Jones & Nigel Spry & Dennis R. Taaffe & David Joseph & Suzanne K. Chambers & Haitham Tuffaha, 2020. "Cost-Effectiveness Analysis of Supervised Exercise Training in Men with Prostate Cancer Previously Treated with Radiation Therapy and Androgen-Deprivation Therapy," Applied Health Economics and Health Policy, Springer, vol. 18(5), pages 727-737, October.
    17. Omar B. Da'ar & Abdi A. Gele, 2023. "Tuberculosis in a weak health system, conflict and fragile zone: The monetary value of human lives lost associated with deaths of persons older than 14 years in Somalia," International Journal of Health Planning and Management, Wiley Blackwell, vol. 38(1), pages 53-68, January.
    18. Fredrik Salvesen Haukaas & Audun Ohna & Tania Krivasi, 2018. "Cost-Effectiveness of Obinutuzumab in Combination with Bendamustine Followed by Obinutuzumab Maintenance versus Bendamustine Alone in Treatment of Patients with Rituximab-Refractory Follicular Lymphom," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 569-577, August.
    19. Frank G. Sandmann & Julie V. Robotham & Sarah R. Deeny & W. John Edmunds & Mark Jit, 2018. "Estimating the opportunity costs of bed‐days," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 592-605, March.
    20. Thai, Thao & Lancsar, Emily & Spinks, Jean & Freeman, Christopher & Chen, Gang, 2024. "Understanding Australian pharmacy degree holders’ job preferences through the lens of motivation-hygiene theory," Social Science & Medicine, Elsevier, vol. 348(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharmo:v:6:y:2022:i:3:d:10.1007_s41669-022-00323-9. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.