Evidence map›Paper›PMID 30832575›Full record

Trial reportBMC geriatrics2019

The cost-effectiveness of a telephone-based intervention to support caregivers of older people discharged from hospital.

David Youens, Richard Parsons, Christine Toye, Susan Slatyer, Samar Aoun, Keith D Hill, Matthew Skinner, Sean Maher, Sue Davis, Rebecca Osseiran-Moisson and 1 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC geriatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. 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

11 authors.

David YouensSchool of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. david.youens@curtin.edu.au.ORCID 0000-0002-4296-4161
Richard ParsonsSchool of Occupational Therapy, Social Work and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.ORCID 0000-0002-5691-0084
Christine ToyeSchool of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.ORCID 0000-0003-4932-0016
Susan SlatyerSchool of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.ORCID 0000-0003-2345-2862
Samar AounSchool of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.ORCID 0000-0002-4073-4805
Keith D HillSchool of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
Matthew SkinnerMedical Division, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA, 6009, Australia.
Sean MaherMedical Division, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA, 6009, Australia.
Sue DavisCorporate Nursing, Research & Education, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA, 6009, Australia.
Rebecca Osseiran-MoissonSchool of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
Rachael MoorinSchool of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.ORCID 0000-0001-8742-7151

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA telephone intervention for caregivers of older people discharged from hospital was shown to improve preparedness to care, reduce caregiver strain and caregiver distress. No cost-effectiveness analysis has been published on this, or similar interventions. The study aims addressed here were to examine whether positive outcomes for caregivers resulting from the Further Enabling Care at Home (FECH) program changed the use and costs of health services by patients; and to assess cost-effectiveness.

methodsA single-blind randomised controlled trial compared FECH to usual care. FECH involved a specially trained nurse addressing support needs of caregivers of older patients discharged from hospital. A minimum clinically important difference in preparedness to care was defined as an increase in Preparedness for Caregiving scale score of ≥ two points from baseline. Designated data collection was at: Time 1, within four days of discharge; Time 2, 15-21 days post-discharge; and Time 3, six weeks post-discharge. A last observation carried forward approach to loss to follow-up was used, with a sensitivity analysis including only those who completed all time points. Patient use of hospital, emergency department (ED) and ambulance services were captured for 12 weeks post-discharge using administrative data. Costs included nurse time supporting caregivers, resources used by the nurse, and time taken training the nurse to deliver FECH. Cost-effectiveness was assessed using decision trees for preparedness for caregiving.

resultsSixty-two intervention dyads and 79 controls provided complete data. A significantly greater proportion of intervention group caregivers reported improved preparedness to care to Time 2 (36.4% v 20.9%, p = 0.029), though this was not sustained to Time 3. The intervention cost $AUD268.28 above usual care per caregiver. No significant differences were observed in health service use between groups. The incremental cost-effectiveness ratio for each additional caregiver reporting improved preparedness to care at Time 2 was $AUD1,730.84.

conclusionsTo our knowledge this is the first work to calculate the cost-effectiveness of a telephone-delivered intervention designed to support caregivers of older people post-discharge, and will support decision-making regarding implementation. Further research should examine different settings, and assess impacts on health service use with larger samples and a longer follow-up.

trial registrationAustralian and New Zealand Clinical Trial Registry: ACTRN12614001174673 . Registered 07/11/2014.

Indexed as

Adaptation, PsychologicalAgedAged, 80 and overAustraliaCaregiversCost-Benefit AnalysisFemaleFollow-Up StudiesFrail ElderlyHumansMaleMiddle AgedPatient DischargeSingle-Blind MethodTelephoneAgedCaregiversCost-effectivenessFamilyHospitalsTelephone based intervention

Identifiers

PMID30832575
PMCPMC6399869

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.