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Pyne, Sarah 
ORCID: https://orcid.org/0000-0003-0093-9125, Sach, Tracey H. ORCID: https://orcid.org/0000-0002-8098-9220, Cameron, Rory ORCID: https://orcid.org/0000-0002-7442-0935, Risebro, Helen, Wright-Hughes, Alexandra, Thompson, Ellen, Watkins, Caroline, Bowen, Audrey, Stevens, Judith, Farrin, Amanda J., McKevitt, Christopher, Murray, John D., O'Connor, Rory J., Phillips, Julie and Radford, Kate A.
and
on behalf of the RETAKE research group
(2024)
Cost consequences analysis of early vocational rehabilitation compared with usual care for stroke survivors.
Clinical Rehabilitation.
ISSN 0269-2155
Abstract
Objective: To compare costs and consequences of Early Stroke Specialist Vocational Rehabilitation (ESSVR) with usual care in working age, stroke survivors over 12 months. Design: An economic evaluation nested within the pragmatic, multi-centre, randomised, controlled RETurn to work After stroKE (RETAKE) study. Setting: Twenty-one English and Welsh National Health Service (NHS) hospital-based stroke units. A UK NHS and Personal Social Services perspective was taken in the base-case and a wider perspective (participant, family, employer and other public services) in a secondary analysis. Participants: A total of 583 stroke survivors age ≥18 years (mean 54.0 years, 69% male). Interventions: Participants were randomised to ESSVR, an early, individually tailored (in content, dose, intensity and duration) intervention, plus usual care or usual care alone. Main measures: Disease-specific resource-use data and EQ-5D-5L (health-related quality of life) collected at baseline, 3, 6 and 12 months. Resource-use items were valued using unit costs in UK£ 2021/22. EQ-5D-5L was used to estimate Quality-adjusted life-years (QALYs). If ESSVR was found effective, an incremental cost-utility analysis was planned, otherwise a cost-consequence analysis. Results: The clinical study found no evidence of a between-group difference in the proportion of participants returning to work at 12 months. This, and the level of missing data, means a cost-consequence analysis is reported. Using imputed data, ESSVR plus usual care is estimated to be more expensive with slightly higher QALYs compared with usual care. Conclusions: Early Stroke Specialist Vocational Rehabilitation is unlikely to be considered cost-effective over 12 months, which fits with the clinical finding of no between-group difference in return-to-work rates post-stroke. Clinical trial registration information: The ISRCTN registry: ISRCTN12464275 https://doi.org/10.1186/ISRCTN12464275
| Item Type: | Article |
|---|---|
| Additional Information: | Data availability statement: Data supporting this work are available on reasonable request. All requests will be reviewed by relevant stakeholders, based on the principles of a controlled access approach. Requests to access data should be made to CTRU-DataAccess@leeds.ac.uk in the first instance. Funding information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the National Institute for Health and Care Research Health Technology Assessment programme (NIHR HTA 15/130/11). The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Centres > Population Health |
| Depositing User: | LivePure Connector |
| Date Deposited: | 27 Nov 2024 10:47 |
| Last Modified: | 09 Dec 2024 01:39 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/97784 |
| DOI: | 10.1177/02692155241299372 |
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