Category Archives: Asthma : Part 4

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Conclusion

When program costs (585€ in the IEP group) are compared to the average cost-of-illness level among study individuals at baseline (approximately 1,200€ per annum in the IEP group), it is not surprising that cost savings did not exceed program costs in the entire study population within the first year after intervention. But given the significant decline in morbidity costs, it can be assumed that a break-even for the entire study population might be arrived at in the subsequent year. In the light of evidence generated in earlier studies that demonstrated that patient education programs yield further cost savings in the long term, it is conceivable that this might also be true for the SPMP (plus IEP). Nevertheless, this assumption will need to be established empirically.
Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Discussion

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: DiscussionThere are various possible explanations for the trend to include more severely ill patients in the intervention groups. First of all, physicians might have a tendency to offer a new technology to more severely ill patients, a phenomenon that is known from other disease areas as “launch bias.” Additionally, asthma-related complications (eg, hospitalization or frequent asthma attacks) could be driving factors. At the same time, negative experiences such as emergency department visits might increase the motivation of patients and caregivers to take part in educational activities. canadian health & care mall

The problem of positive selection could have been avoided by randomization of patients. This was not done for two reasons: First of all, potential candidates with poor asthma control and an urgent need for educational activities could have been prevented from being randomized to one of the two intervention groups. The study investigators had rejected this approach categorically at an initial study conference: no one was ready to accept that severely ill patients would be barred from a scientifically proven intervention such as the SPMP in case of being randomized to a CG.
Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: IEP Use

On average, patients were logged in to the IEP for 2 h/mo, as indicated by the provider who maintains the IEP. The peak flow protocol section, the patient chat room, and the asthma adventure game were the most widely used modules.
The positive impact of the SPMP is fortified by the additional IEP as demonstrated in several outcome measures, including morbidity costs savings, QoL, absenteeism from school, number of asthma-related emergencies, and use of short-acting (3-agonists. Our subgroup analysis demonstrates that, within 1 year, morbidity cost savings exceed the intervention costs in patients who belong to risk groups (benefit-cost ratio > 1). Similar findings that reflect the influence of target population characteristics on the results can be found for other asthma education programs in the literature. this

Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Sensitivity Analysis

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Sensitivity AnalysisFrom a health-care insurance perspective, it cost 585€ to deliver education including the IEP; 461€ was saved in health expenses. Adjusting for benefits in the control group, 0.79€ was saved for every 1.00€ spent in the first year after intervention.
Adding the IEP to the SPMP yields incremental morbidity cost savings of 160€ (direct costs) at an additional average cost of 44€ when compared to the SPMP alone. This translates into a benefit-cost ratio of 3.65.
Lung function as measured with PEF increased significantly (p > 0.05) in all study groups. FEV1 did not change significantly over time in any of the three groups. Changes in lung function are shown in Table 7. Subgroup analysis of the main study outcome shows higher benefit-cost ratios for patients with moderate persistent or severe persistent asthma (1.42 in the IEP group) and for patients with any emergency 6 months prior to the study entry (1.21 in the IEP group) [Table 6]. this

Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Research

Table 4 shows major characteristics of the PPP and the group of noncompleters at baseline assessment. Patients who did not complete the study tended to use more health-care resources. Among the patients who were assigned to the intervention groups, study completers had significantly lower morbidity costs at baseline when compared to noncompleters.
The medical outcomes of the PPP are summarized in Table 5. Various improvements were reported in all study groups, but patients using the IEP were the only ones to experience a statistically significant short-term reduction in asthma-related emergencies and a long-term decrease in the daily use of rescue medication. During the follow-up year, morbidity costs savings in the IEP group were due to a reduction in physician consultations (56%), asthma-related emergency treatments (75%), and daily medication costs (52%) [Fig 2].
Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Results

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: ResultsResults are presented as severity-adjusted mean scores for the population per peer protocol (PPP), for subgroups, and for the intention-to-treat (ITT) population. As a standard in health economic evaluations, one-way sensitivity analyses were performed in order to test for the influence of variations in drug therapy adherence, outpatient visit costs, and intervention costs on the benefit-cost ratio. The data were analyzed using statistical software (Version 10.0; SPSS; Chicago, IL).
The original study sample consisted of 358 patients. A further 80 patients were interested in participating but could not be included as they did not meet inclusion criteria. Complete medical resource use data at all follow-up visits were available for 178 patients (49.7%) who were defined as PPP (Table 2). Medical resource use data of 56 study completers were insufficient for analysis (15.6%).
Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Analysis

We arrived at the adjusted benefit in the intervention groups by accounting for potential savings or excess expenditures in the CG (adjusted benefit = savings — [costs CG at visit 1 X 2 – costs CG at visit 2 X 2]). The net benefit in the first year after intervention was calculated by subtracting the intervention costs from the adjusted benefit. Finally, the benefit-cost ratio was determined as the ratio of adjusted benefits and intervention costs. The same method was used to calculate the incremental savings and benefits of the educational activities including the IEP when compared to standard patient education.
Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Direct Medical Costs

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Direct Medical CostsThe following asthma-related morbidity measures were calculated for each of the three study groups: average rate of scheduled and unscheduled medical care visits, rate of emergency department visits, and frequency and length of inpatient stays. The monetary values of these measures were determined according to recent estimates and national statistics. Daily asthma medication costs were calculated based on physicians prescription records. Costs for traditional patient education were derived from existing reimbursement contracts between paymasters and providers and are on a comparable level nationwide. A sickness fund with a market share of approximately 11% reimburses the additional costs of the IEP depending on frequency of use and performance shown by the patient. For the calculation of incremental costs in the IEP group, it was assumed that reimbursement was secured for all participating patients. www.mycanadianpharmacy.com

Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Additional Education in the IEP Group

Patients in the intervention groups were allowed to self select the IEP as an additional module. The IEP (www.forum-telemedizin.de, now www.asthmax.de) includes an additional educational module with an asthma-related quiz and an interactive adventure game incorporating numerous virtual asthma-related situations that have to be managed adequately. Furthermore, a repetition section displaying the educational material of the SPMP is included. In addition, the IEP provides a medical module with individual medication plans, scheduled chats with asthma experts, and an on-line peak flow protocol that is to be maintained by the patient. Communication of registered users, both patients and health-care providers, is feasible in chat rooms or by e-mail. Content for the IEP had been developed by a multidisciplinary team. Over a 6-month period, the IEP was tested successfully in a focus group including 50 children in an inpatient setting. read

Continue reading

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: Intervention

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents: InterventionClinical outcomes and health-care resource use data were documented by treating physicians based on (electronic) patient records. Documentation covered the 6-month periods prior to the baseline and subsequent follow-up visits. An additional caregiver questionnaire provided information about patients’ school absenteeism, caregivers’ loss of workdays due to their child’s asthma, and the number of asthma-related emergencies.
Finally, a patient questionnaire was distributed at all scheduled study visits. It contained a QoL questionnaire (KINDL; Berlin, Germany). The KINDL questionnaire is a generic QoL instrument applicable for self administration. It consists of 24 Likert-scale items in the dimensions of physical well-being, psychological well-being, self esteem, family, friends, and social functioning. Furthermore, it is supplemented with a disease-specific asthma module consisting of six further items. canadian pharmacy

Continue reading

Pages: Prev 1 2 3 4 5 6 7 8 Next