Evidence map›Paper›PMID 30556300›Full record

ArticleInternational journal of rheumatic diseases2019

Cost-effectiveness of an adherence-enhancing intervention for gout based on real-world data.

Lydia Wenxin Lin, Gim Gee Teng, Anita Yee Nah Lim, Joanne Su-Yin Yoong, Niklas Zethraeus, Hwee-Lin Wee

Open access · hybridAbstract read
In one paragraph

Article in International journal of rheumatic diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 26% 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

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
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

6 authors at 2 institutions in 2 countries.

Lydia Wenxin LinSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.ORCID https://orcid.org/0000-0001-6203-081X
Gim Gee TengDivision of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore.
Anita Yee Nah LimDivision of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore.
Joanne Su-Yin YoongSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Niklas ZethraeusDepartment of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Hwee-Lin WeeSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
National University of Singapore · SGKarolinska Institutet · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimMedication non-adherence influences outcomes of therapies for chronic diseases. Allopurinol is a cornerstone therapy for patients with gout; however, non-adherence to allopurinol is prevalent in Singapore and limits its effectiveness. Between 2008-2010, an adherence-enhancing program was implemented at the rheumatology division of a public tertiary hospital. The cost-effectiveness of this program has not been fully evaluated. With healthcare resources being finite, the value of investing in adherence-enhancing interventions should be ascertained. This study aims to evaluate the cost-effectiveness of this adherence-enhancing program to inform optimal resource allocation toward better gout management.

methodAdopting a real-world data approach, we utilized patient clinical and financial records generated in their course of routine care. Intervention and control groups were identified in a standing database and matched on nine risk factors through propensity score matching. Cost and effect data were followed through 1-2 years. A decision tree was developed in TreeAge using a societal perspective. Deterministic and probabilistic sensitivity analyses were performed to assess parameter uncertainty.

resultsAt an assumed willingness-to-pay threshold of $50 000 USD ($70 000 SGD) per quality-adjusted life year (QALY), the intervention had an 85% probability of being cost-effective compared to routine care. The incremental cost-effectiveness ratio was $12 866 USD per QALY for the base case and ranged from $4 139 to $21 593 USD per QALY in sensitivity analyses.

conclusionThe intervention is cost-effective in the short-term, although its long-term cost-effectiveness remains to be evaluated.

Indexed as

Health Care CostsMedication AdherenceAdultAgedAllopurinolCost-Benefit AnalysisCost of IllnessDecision TreesDrug CostsFemaleGoutGout SuppressantsHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedAllopurinolGout Suppressantsallopurinolcost-effectiveness analysiselectronic medical recordsgoutmedication adherencequality-adjusted life year

Identifiers

PMID30556300
PMCPMC6590285
OpenAlexW2903598520

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.