ArticleBMC palliative care2020
Cost-effectiveness analysis of systematic fast-track transition from oncological treatment to specialised palliative care at home for patients and their caregivers: the DOMUS trial.
Article in BMC palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01885637 (DOMUS), which is not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
DOMUS: A Randomized Controlled Clinical Trial of Accelerated Transition From Oncological Treatment to Continuing Palliative Care at Home
Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Economic evaluations in the palliative and end-of-life care settings: A systematic review of existing evidence, methods and quality.Palliative medicine · 2026Pooled it
- Quality indicators for integrating oncology and home palliative care in Japan: modified Delphi study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Pooled it
- Interventions to Support Transitions in Care Among Patients With Cancer: A Scoping Review.Cancer medicine · 2025Article
- The complex intervention day hospice - a quality-assured study on the implementation, realization, and benefits with model character for Germany (IMPULS) using the example of "Day hospice Adiuvantes".BMC palliative care · 2024Article
- Systematic Review of the Cost-Effectiveness of Home-Based Palliative Care Interventions in Patients with Cancer: A Critical Analysis.Cancer management and research · 2024Review
- Willingness of advanced cancer patients to receive palliative care and its determinants: A cross-sectional study in Northern Tanzania.PloS one · 2023Article
- Economic Evaluation of Palliative Care for Patients with Cancer Disease: A Systematic Review.Medical journal of the Islamic Republic of Iran · 2022Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile hospitals remain the most common place of death in many western countries, specialised palliative care (SPC) at home is an alternative to improve the quality of life for patients with incurable cancer. We evaluated the cost-effectiveness of a systematic fast-track transition process from oncological treatment to SPC enriched with a psychological intervention at home for patients with incurable cancer and their caregivers.
methodsA full economic evaluation with a time horizon of six months was performed from a societal perspective within a randomised controlled trial, the DOMUS trial ( Clinicaltrials.gov : NCT01885637). The primary outcome of the health economic analysis was a incremental cost-effectiveness ratio (ICER), which is obtained by comparing costs required per gain in Quality-Adjusted Life Years (QALY). The costs included primary and secondary healthcare costs, cost of intervention and informal care from caregivers. Public transfers were analysed in seperate analysis. QALYs were measured using EORTC QLQ-C30 for patients and SF-36 for caregivers. Bootstrap simulations were performed to obtain the ICER estimate.
resultsIn total, 321 patients (162 in intervention group, 159 in control group) and 235 caregivers (126 in intervention group, 109 in control group) completed the study. The intervention resulted in significantly higher QALYs for patients when compared to usual care (p-value = 0.026), while being more expensive as well. In the 6 months observation period, the average incremental cost of intervention compared to usual care was €2015 per patient (p value < 0.000). The mean incremental gain was 0.01678 QALY (p-value = 0.026). Thereby, the ICER was €118,292/QALY when adjusting for baseline costs and quality of life. For the caregivers, we found no significant differences in QALYs between the intervention and control group (p-value = 0.630). At a willingness to pay of €80,000 per QALY, the probability that the intervention is cost-effective lies at 15% in the base case scenario.
conclusionThis model of fast-track SPC enriched with a psychological intervention yields better QALYs than usual care with a large increase in costs.
trial registrationThe trial was prospectively registered 25.6.2013. Clinicaltrials.gov Identifier: NCT01885637 .
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