Evidence map›Paper›PMID 31397022›Full record

Trial reportJournal of intellectual disability research : JIDR2019

The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study.

M Pennington, H Ring, J Howlett, C Smith, M Redley, C Murphy, R Hook, A Platt, N Gilbert, E Jones and 7 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of intellectual disability research : JIDR, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 38% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Further advances in epilepsy.Journal of neurology · 2023
    Review
  6. 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

17 authors at 8 institutions in 1 country.

M PenningtonDepartment of Health Services and Population Research, King's Health Economics, PO24, David Goldberg Centre, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0002-1392-8700
H RingDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
J HowlettMRC Biostatistics Unit, University of Cambridge, Institute of Public Health, Cambridge, UK.
C SmithDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
M RedleyDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
C MurphyKing's Clinical Trials Unit, PO64 Institute of Psychiatry, King's College London, London, UK.
R HookDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
A PlattDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
N GilbertDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
E JonesDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
J KellyKing's Clinical Trials Unit, PO64 Institute of Psychiatry, King's College London, London, UK.
A PullenEpilepsy Action, New Antsey House, Leeds, UK.
A ManderNIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England, Cambridge, UK.
C DonaldsonYunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK.
S RoweFinance and Contracts, NHS Wakefield Clinical Commissioning Group, Wakefield, UK.
J WasonMRC Biostatistics Unit, University of Cambridge, Institute of Public Health, Cambridge, UK.
F IrvineSchool of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
University of Cambridge · GBKing's College London · GBBirmingham Dental Hospital · GBGlasgow Caledonian University · GBLeeds Teaching Hospitals NHS Trust · GBNational Institute for Health Research · GBPolice and Crime Commissioner for West Yorkshire · GBUniversity of East Anglia · GB

Funding

Department of Health 10/104/16Medical Research Council MC_UU_00002/6
6 · The paper itself

Abstract

backgroundThe development of a nurse-led approach to managing epilepsy in adults with an intellectual disability (ID) offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of ID nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs.

methodAcross the United Kingdom, eight sites randomly allocated to the intervention recruited 184 participants and nine sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after 6 months. Total costs at 6 months were compared from the perspective of health and social services and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data were imputed using multiple imputation. Uncertainty was quantified by bootstrapping.

resultsThe intervention was associated with lower per participant costs from a health and social services perspective of -£357 (2014/2015 GBP) (95% confidence interval -£986, £294) and from a societal perspective of -£631 (95% confidence interval -£1473, £181). Results were not sensitive to the exclusion of accommodation costs.

conclusionsOur findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and ID and may reduce costs.

Indexed as

Clinical CompetenceCommunity Health ServicesHealth Care CostsNursesPatient Care TeamProcess Assessment, Health CareAdultComorbidityEpilepsyHumansIntellectual Disabilitycompetency frameworkcostepilepsyintellectual disabilitymanagement(name removed for blinded review)

Identifiers

PMID31397022
PMCPMC7613974
OpenAlexW2967534787

What OpenQuestion holds

Textmetadata
LicenceTDM
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.