Evidence map›Paper›PMID 40555443›Full record

Trial reportBMJ open2025

Cost-effectiveness analysis of the Assessment of Burden of Chronic Conditions (ABCC) tool in primary care in the Netherlands.

Loraine Hl Peters, Manuela A Joore, Annerika Hm Gidding-Slok, Lotte Cem Keijsers, Mascha Twellaar, Esther A Boudewijns, Onno Cp van Schayck, Jean Wm Muris, Merel L Kimman

Registry-linked trialAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04127383 (Effectiveness, Cost-effectiveness and Implementation of the Assessment of Burden of Chronic Conditions), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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.

NCT04127383 nacompletednot on this map

Effectiveness, Cost-effectiveness and Implementation of the Assessment of Burden of Chronic Conditions (ABCC)-Tool in Patients With COPD, Asthma, Diabetes Mellitus Type 2 and Heart Failure: a Pragmatic Clustered Quasi-experimental Study

TypeinterventionalSponsorMaastricht UniversityRan2019 to 2022Enrolled237ConditionsChronic Obstructive Pulmonary Disease, Asthma, Diabetes Mellitus, Type 2, Heart FailureArmsAssessment of Burden of Chronic Conditions (ABCC)-tool
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  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

9 authors.

Loraine Hl PetersDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands loraine.peters@maastrichtuniversity.nl.ORCID http://orcid.org/0009-0009-6712-3180
Manuela A JooreDepartment of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands.
Annerika Hm Gidding-SlokDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Lotte Cem KeijsersDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Mascha TwellaarDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Esther A BoudewijnsDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Onno Cp van SchayckDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Jean Wm MurisDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.ORCID http://orcid.org/0000-0002-8780-476X
Merel L KimmanDepartment of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe increasing prevalence of chronic conditions and multimorbidity places a significant burden on patients and leads to increasing challenges for healthcare systems, especially in primary care. Recognising the multifaceted nature of chronic conditions, the Assessment of Burden of Chronic Conditions (ABCC) tool was developed to support person-centred care, by facilitating shared decision-making and self-management. This study aims to evaluate the cost-effectiveness of the ABCC tool in primary care. DESIGN AND

settingThis cost-effectiveness analysis was conducted over 18 months alongside a clustered, two-arm quasi-experimental study in primary care in the Netherlands.

participantsThe study included 231 participants diagnosed with chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes mellitus (T2DM) and/or chronic heart failure (CHF). Of these, 173 were assigned to the intervention group and 58 to the control group.

interventionsThe intervention group was intended to incorporate the ABCC tool into routine consultations, while the control group had to continue care as usual. OUTCOME MEASURES: Outcomes were assessed from a societal perspective, including quality-adjusted life years (QALYs) derived via the EuroQol-5D-5L (EQ-5D-5L) questionnaire. Costs were measured using adapted versions of the Productivity Costs Questionnaire (PCQ) and Medical Consumption Questionnaire (MCQ). Sensitivity analyses (SAs) included a healthcare perspective, per-protocol analysis (to account for disruptions caused by COVID-19) and exclusion of home care costs (to address extreme outliers). Moreover, all analyses were performed for well-being-adjusted life years (WALYs), derived from the ICEpop CAPability measure for Adults (ICECAP-A) questionnaire.

resultsThe ABCC tool was more expensive and effective than usual care, with an incremental cost-effectiveness ratio (ICER) of €64 525 per QALY and a 29% probability of cost-effectiveness. With the exception of the healthcare perspective, the SAs yielded more favourable outcomes in terms of cost-effectiveness, with ICERs (probability of cost-effectiveness) of €41 484 (31%), €8683 (58%) and €23 905 (48%) for a healthcare perspective, per-protocol analysis and exclusion of home care costs, respectively. Outcomes for QALY and WALY were comparable.

conclusionWhile the primary analysis suggested a relatively low probability of cost-effectiveness, the SAs showed higher probabilities. The per-protocol analysis suggested that the ABCC tool can be cost-effective when actually used. TRIAL REGISTRATION NUMBER: NCT04127383.

Indexed as

Cost-Benefit AnalysisCost of IllnessPrimary Health CareAgedAsthmaChronic DiseaseCost-Effectiveness AnalysisDiabetes Mellitus, Type 2FemaleHeart FailureHumansMaleMiddle AgedNetherlandsPulmonary Disease, Chronic ObstructiveQuality-Adjusted Life YearsChronic DiseaseHEALTH ECONOMICSPerson-Centered CarePrimary Health CareSelf-Management

Identifiers

PMID40555443
PMCPMC12198781

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Registered trials

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.