Evidence map›Paper›PMID 25995238›Full record

Trial reportBMJ open2015

Cost-effectiveness of a nurse-led internet-based vascular risk factor management programme: economic evaluation alongside a randomised controlled clinical trial.

J P Greving, H A H Kaasjager, J W P Vernooij, M M C Hovens, J Wierdsma, H M H Grandjean, Y van der Graaf, G A de Wit, F L J Visseren

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00785031 (Internet-based Vascular Risk Factor Management for Patients With Clinical Manifest Vascular Disease; a Randomized Controlled Trial), which is not on this map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00785031 nacompletednot on this map

Internet-based Vascular Risk Factor Management for Patients With Clinical Manifest Vascular Disease; a Randomized Controlled Trial

TypeinterventionalSponsorUMC UtrechtRan2008 to 2011Enrolled330ConditionsCardiovascular DiseasesArmsinternet based vascular risk factor intervention
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

J P GrevingJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
H A H KaasjagerDepartment of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
J W P VernooijDepartment of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
M M C HovensDepartment of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
J WierdsmaDepartment of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
H M H GrandjeanDepartment of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
Y van der GraafJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
G A de WitJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
F L J VisserenDepartment of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
University Medical Center Utrecht · NLRijnstate Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the cost-effectiveness of an internet-based, nurse-led vascular risk factor management programme in addition to usual care compared with usual care alone in patients with a clinical manifestation of a vascular disease.

designCost-effectiveness analysis alongside a randomised controlled trial (the Internet-based vascular Risk factor Intervention and Self-management (IRIS) study).

settingMulticentre trial in a secondary and tertiary healthcare setting.

participants330 patients with a recent clinical manifestation of atherosclerosis in the coronary, cerebral, or peripheral arteries and with ≥2 treatable vascular risk factors not at goal.

interventionThe intervention consisted of a personalised website with an overview and actual status of patients' vascular risk factors, and mail communication with a nurse practitioner via the website for 12 months. The intervention combined self-management support, monitoring of disease control and pharmacotherapy.

main outcome measuresSocietal costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness.

resultsPatients experienced equal health benefits, that is, 0.86 vs 0.85 QALY (intervention vs usual care) at 1 year. Adjusting for baseline differences, the incremental QALY difference was -0.014 (95% CI -0.034 to 0.007). The intervention was associated with lower total costs (€4859 vs €5078, difference €219, 95% CI -€2301 to €1825). The probability that the intervention is cost-effective at a threshold value of €20,000/QALY, is 65%. At mean annual cost of €220 per patient, the intervention is relatively cheap.

conclusionsAn internet-based, nurse-led intervention in addition to usual care to improve vascular risk factors in patients with a clinical manifestation of a vascular disease does not result in a QALY gain at 1 year, but has a small effect on vascular risk factors and is associated with lower costs. TRIAL REGISTRATION NUMBER: NCT00785031.

Indexed as

Self CareTelemedicineAtherosclerosisCost-Benefit AnalysisDelivery of Health CareHumansInternetModels, EconomicOnline SystemsProgram EvaluationQuality-Adjusted Life YearsQuality of LifeRisk FactorsTreatment OutcomeEPIDEMIOLOGYHEALTH ECONOMICSVASCULAR MEDICINE

Identifiers

PMID25995238
PMCPMC4442232
OpenAlexW1569765392

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.