Resource use and cost associated with computerized decision support system and usual care in managing patients with atrial fibrillation: analysis of IMPACT-AF randomized trial data.

Humans Atrial Fibrillation / therapy Prospective Studies Canada Hospitalization
Atrial fibrillation Costs Decision support tool Randomized controlled trial Resource utilization

Journal

BMC medical informatics and decision making
ISSN: 1472-6947
Titre abrégé: BMC Med Inform Decis Mak
Pays: England
ID NLM: 101088682

Informations de publication

Date de publication:
18 10 2023
Historique:
received: 19 06 2023
accepted: 06 10 2023
medline: 23 10 2023
pubmed: 19 10 2023
entrez: 18 10 2023
Statut: epublish

Résumé

IMPACT-AF is a prospective, randomized, cluster design trial comparing atrial fibrillation (AF) management with a computerized decision support system (CDS) to usual care (control) in the primary care setting of Nova Scotia, Canada. The objective of this analysis was to compare the resource use and costs between CDS and usual care groups. Case costing data, 12-month self-administered questionnaires, and monthly diaries from IMPACT-AF were used in this analysis. Descriptive statistics were used to compare costs and resource use between groups. All costs are presented in 2021 Canadian dollars and cover the 12-month period of participation in the study. A total of 1,145 patients enrolled in the trial. Case costing data were available for 466 participants (41.1%), 12-month self-administered questionnaire data for 635 participants (56.0%) and monthly diary data for 223 participants (19.7%). Emergency department visits and hospitalizations comprised the most expensive component of AF care. Across all three datasets, there were no statistically significant differences in costs or resource use between CDS and usual care groups. Although there were no significant differences in resource use or costs among CDS and usual care groups in the IMPACT-AF trial, this study provides insight into the methodology and practical challenges of collecting economic data alongside a trial. Clinicaltrials.gov (registration number: NCT01927367, date of registration: 2013-08-20).

Sections du résumé

BACKGROUND
IMPACT-AF is a prospective, randomized, cluster design trial comparing atrial fibrillation (AF) management with a computerized decision support system (CDS) to usual care (control) in the primary care setting of Nova Scotia, Canada. The objective of this analysis was to compare the resource use and costs between CDS and usual care groups.
METHODS
Case costing data, 12-month self-administered questionnaires, and monthly diaries from IMPACT-AF were used in this analysis. Descriptive statistics were used to compare costs and resource use between groups. All costs are presented in 2021 Canadian dollars and cover the 12-month period of participation in the study.
RESULTS
A total of 1,145 patients enrolled in the trial. Case costing data were available for 466 participants (41.1%), 12-month self-administered questionnaire data for 635 participants (56.0%) and monthly diary data for 223 participants (19.7%). Emergency department visits and hospitalizations comprised the most expensive component of AF care. Across all three datasets, there were no statistically significant differences in costs or resource use between CDS and usual care groups.
CONCLUSIONS
Although there were no significant differences in resource use or costs among CDS and usual care groups in the IMPACT-AF trial, this study provides insight into the methodology and practical challenges of collecting economic data alongside a trial.
REGISTRATION
Clinicaltrials.gov (registration number: NCT01927367, date of registration: 2013-08-20).

Identifiants

DOI: 10.1186/s12911-023-02329-7 PMID: 37853351 PMC: PMC10585905
pubmed: 37853351
doi: 10.1186/s12911-023-02329-7
pii: 10.1186/s12911-023-02329-7
pmc: PMC10585905
doi:

Banques de données

ClinicalTrials.gov
['NCT01927367']

Types de publication

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

228

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Brittany Humphries (B)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.

Jafna L Cox (JL)

Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Heart and Stroke Foundation of Nova Scotia Endowed Chair in Cardiovascular Outcomes Research, Halifax, NS, Canada.

Ratika Parkash (R)

Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.

Lehana Thabane (L)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Research Institute of St Joes Hamilton, St. Joseph's Healthcare, Hamilton, ON, Canada.
Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.
Departments of Anesthesia/Pediatrics, McMaster University, Hamilton, ON, Canada.
Biostatistics Unit, The Research Institute, St Joseph's Healthcare, Hamilton, ON, Canada.
Population Health Research Institute (PHRI), Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.

Gary A Foster (GA)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Biostatistics Unit, The Research Institute, St Joseph's Healthcare, Hamilton, ON, Canada.

James MacKillop (J)

Sydney Primary Care Medical Clinic, Sydney, NS, Canada.

Joanna Nemis-White (J)

Strive Health Management Consulting Ltd, Halifax, NS, Canada.

Laura Hamilton (L)

QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, NS, Canada.

Antonio Ciaccia (A)

Medical Affairs - Cardiovascular Medicine, Bayer Inc, Mississauga, ON, Canada.

Shurjeel H Choudhri (SH)

Medical & Scientific Affairs, Bayer Inc, Mississauga, ON, Canada.

Bruno Kovic (B)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.

Feng Xie (F)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. fengxie@mcmaster.ca.
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada. fengxie@mcmaster.ca.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Resource use and cost associated with...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Resource use and cost associated with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Resource use and cost associated with...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › Canada › Resource use and cost associated with...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Resource use and cost associated with...