ONE-YEAR ECONOMIC-EVALUATION OF INTENSIVE VS CONVENTIONAL PATIENT EDUCATION AND SUPERVISION FOR SELF-MANAGEMENT OF NEW ASTHMATIC-PATIENTS

The purpose was to compare the short-term cost-effectiveness of intens ive vs conventional education and supervision for the self-management of mild asthmatic patients, Consecutive newly diagnosed asthmatic pati ents (n = 162) were randomized into an intervention group (IG) and a c ontrol group (CG with 1 yr of treatment and follow-up. Intensive educa tion was given to 77 patients at visits every third month in the outpa tient clinic. Eighty CG patients received conventional education and a dvice at the baseline visit only. All patients received similar inhale d anti-inflammatory treatment. At baseline and at 12 months standard c linical lung functions and health-related quality of life (HRQOL) were measured, the latter by the disease-specific St George's Respiratory Questionnaire and the generic 15D. Furthermore, the use of extra healt h care services, medication and sickness days were recorded, The IG ex perienced a significant improvement in all clinical and HRQOL outcome variables. The same applied to the CG except spirometric values. The g roups differed significantly only in terms of FEV, (P<0.05) in favour of the IG, There was a significant difference between the groups in ex tra costs. The mean cost was FIM 2351 per patient (pound 294 sterling) in the CG and FIM 2757 per patient (pound 345) in the IG, of which th e intervention cost was FIM 1978 per patient (pound 247). In 1 yr foll ow-up the intensive education programme did not prove to be cost effec tive but was dominated by the conventional one regardless of what effe ctiveness measure was used. Also, a purely monetary cost-benefit calcu lation showed that the intervention resulted in a negative net benefit (loss) of FIMI 406 per patient (pound 51), a longer follow-up may be needed before definitive conclusions about the cost-effectiveness of t his kind of intervention can be drawn.