Evidence map›Paper›PMID 35316523›Full record

ArticlePharmacoEconomics - open2022

Cost-Effectiveness of Constraint-Induced Movement Therapy Implementation in Neurorehabilitation: The ACTIveARM Project.

Lauren J Christie, Nicola Fearn, Annie McCluskey, Meryl Lovarini, Reem Rendell, Alison Pearce

Open access · goldAbstract read
In one paragraph

Article in PharmacoEconomics - open, 2022. 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
0.5field-weighted citation impact, top 35% 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, 5 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 1 institution in 1 country.

Lauren J ChristieBrain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, NSW, Australia. lauren.christie@svha.org.au.ORCID http://orcid.org/0000-0003-4900-5614
Nicola FearnBrain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0002-9332-1043
Annie McCluskeyDiscipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0002-9719-6657
Meryl LovariniDiscipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0003-4304-0793
Reem RendellBrain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0001-7522-3012
Alison PearceSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0002-5690-9542
The University of Sydney · AU

Funding

NSW Ministry of Health 28
6 · The paper itself

Abstract

backgroundConstraint-induced movement therapy (CIMT) is a recommended intervention for improving arm recovery following stroke and traumatic brain injury; however, delivery in practice remains rare. PURPOSE: The aim of this study was to investigate the costs and cost effectiveness of CIMT delivery, and the use of a CIMT implementation package designed to improve CIMT uptake and delivery by therapists in Sydney, Australia.

methodsThis economic evaluation was conducted with a subset of CIMT programmes (n = 20) delivered by neurological rehabilitation teams at five varied hospitals within a mixed methods implementation study (ACTIveARM). The costs of delivering the CIMT implementation package and publicly funded CIMT were calculated using a bottom-up approach. A cost-effectiveness analysis was conducted, using decision analytic modelling. We compared the uptake and outcomes of people who received CIMT from health services that had received a CIMT implementation package, with those receiving standard upper limb therapy. An Australian health care system perspective was used in the model, over a 3-week time horizon (the average timeframe of a CIMT programme). All costs were calculated in Australian dollars (AUD). Inputs were derived from the ACTIveARM study and relevant literature. The Action Research Arm Test was used to measure arm outcomes. Sensitivity analyses assessed the impact of improving CIMT uptake, scale-up of the implementation package and resource adjustment, including a 'best-case' scenario analysis.

resultsThe total cost of delivering the implementation package to nine teams across five hospitals was $110,336.43 AUD over 18 months. The mean cost of delivering an individual CIMT programme was $1233.38 AUD per participant, and $936.03 AUD per participant for group-based programmes. The incremental cost-effectiveness ratio (ICER) of individual CIMT programmes was $8052 AUD per additional person achieving meaningful improvement in arm function, and $6045 AUD for group-based CIMT. The ICER was most sensitive to reductions in staffing costs. In the 'best-case' scenario, the ICER for both individual and group-based CIMT was $245 AUD per additional person gaining a meaningful change in function.

conclusionTherapists improved CIMT uptake and delivery with the support of an implementation package, however cost effectiveness was unclear. CLINICAL

trial registrationhttps://anzctr.org.au/Trial ID: ACTRN12617001147370.

Identifiers

PMID35316523
PMCPMC9043065
OpenAlexW4220785678

What OpenQuestion holds

Textmetadata
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.