Evidence map›Paper›PMID 26525419›Full record

ArticleBMJ open2015

Cost-effectiveness of integrated COPD care: the RECODE cluster randomised trial.

Melinde R S Boland, Annemarije L Kruis, Apostolos Tsiachristas, Willem J J Assendelft, Jacobijn Gussekloo, Coert M G Blom, Niels H Chavannes, Maureen P M H Rutten-van Mölken

Open access · goldAbstract readControlled Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 4 pooled it
2.4field-weighted citation impact, top 11% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.

  1. Pooled it
  2. Cost and effects of integrated care: a systematic literature review and meta-analysis.The European journal of health economics : HEPAC : health economics in prevention and care · 2020
    Pooled it
  3. Pooled it
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  5. Trial
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  10. Article
  11. Article
  12. Review
  13. Cost-Effectiveness Analysis of Integrated Care in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD).Medical science monitor : international medical journal of experimental and clinical research · 2019
    Article
  14. Article
  15. Review
  16. Impact of Integrated Care Model (ICM) on Direct Medical Costs in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD).Medical science monitor : international medical journal of experimental and clinical research · 2017
    Article
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  18. Observational
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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

8 authors at 4 institutions in 2 countries.

Melinde R S BolandInstitute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
Annemarije L KruisDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Apostolos TsiachristasInstitute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK.
Willem J J AssendelftDepartment of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Jacobijn GusseklooDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Coert M G BlomStichting Zorgdraad foundation, Oosterbeek, The Netherlands.
Niels H ChavannesDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Maureen P M H Rutten-van MölkenInstitute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
Erasmus University Rotterdam · NLLeiden University Medical Center · NLRadboud University Medical Center · NLStichting Zorgdraad · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the cost-effectiveness of a chronic obstructive pulmonary disease (COPD) disease management (COPD-DM) programme in primary care, called RECODE, compared to usual care.

designA 2-year cluster-randomised controlled trial.

setting40 general practices in the western part of the Netherlands.

participants1086 patients with COPD according to GOLD (Global Initiative for COPD) criteria. Exclusion criteria were terminal illness, cognitive impairment, alcohol or drug misuse and inability to fill in Dutch questionnaires. Practices were included if they were willing to create a multidisciplinary COPD team.

interventionsA multidisciplinary team of caregivers was trained in motivational interviewing, setting up individual care plans, exacerbation management, implementing clinical guidelines and redesigning the care process. In addition, clinical decision-making was supported by feedback reports provided by an ICT programme.

main outcome measuresWe investigated the impact on health outcomes (quality-adjusted life years (QALYs), Clinical COPD Questionnaire, St. George's Respiratory Questionnaire and exacerbations) and costs (healthcare and societal perspective).

resultsThe intervention costs were €324 per patient. Excluding these costs, the intervention group had €584 (95% CI €86 to €1046) higher healthcare costs than did the usual care group and €645 (95% CI €28 to €1190) higher costs from the societal perspective. Health outcomes were similar in both groups, except for 0.04 (95% CI -0.07 to -0.01) less QALYs in the intervention group.

conclusionsThis integrated care programme for patients with COPD that mainly included professionally directed interventions was not cost-effective in primary care. TRIAL REGISTRATION NUMBER: Netherlands Trial Register NTR2268.

Indexed as

Cost-Benefit AnalysisDisease ManagementHealth Care CostsPatient Care TeamPrimary Health CareQuality of LifeAgedFemaleGeneral PracticeHumansMaleMiddle AgedMotivational InterviewingNetherlandsProgram EvaluationPulmonary Disease, Chronic ObstructiveHEALTH ECONOMICSPRIMARY CARERESPIRATORY MEDICINE (see Thoracic Medicine)

Identifiers

PMID26525419
PMCPMC4636669
OpenAlexW2167487355

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.