Assessing the cost-effectiveness of RT Prepare: A radiation therapist-delivered intervention for reducing psychological distress prior to radiotherapy

RT Prepare Project Team

Research output: Contribution to journalArticle

Abstract

Objective To determine the cost-effectiveness of RT Prepare in reducing breast cancer patients' psychological distress before treatment, compared with usual care. Methods RT Prepare, an intervention involving patient education and support consultations with a radiation therapist (RT), was implemented at three Australian sites (Australian New Zealand Clinical Trials Registration: ACTRN12611001000998). The primary outcome was change in psychological distress using the Hospital Anxiety and Depression Scale (HADS); secondary outcomes were changes in quality of life (QoL) and additional health service use. Costs (2015 $AU) included consultation time and training delivery. Between-group comparisons of HADS and QoL used generalised linear mixed models, and comparisons of health service use used negative binomial regression. Incremental cost-effectiveness ratios (ICERs) indicated mean costs per 1-point decrease in HADS score. Sensitivity analyses explored variation in facility size and uncertainty in intervention effectiveness. Results Among 218 controls and 189 intervention participants, the intervention significantly lowered HADS scores at treatment commencement (adjusted mean difference 1.06 points). There was no significant effect on QoL or additional service use. Mean intervention costs were AU$171 per participant (US$130, euro119) mostly related to RT training (approximately AU$142 (US$108, euro99). An ICER of $158 (US$120, euro110) was estimated. Cost-effectiveness improved in a sensitivity analysis representing a large facility with higher patient numbers. Conclusion This study provides new data on the cost-effectiveness of an RT-delivered intervention to reduce psychological distress prior to treatment, which will be useful to inform delivery of similar services. As most costs were upfront, cost-effectiveness would likely improve if implemented as standard care.

Original languageEnglish
Pages (from-to)1110-1118
Number of pages9
JournalPsycho-Oncology
Volume28
Issue number5
DOIs
Publication statusPublished - May 2019

Cite this

@article{117963bfa5be468791c569b1fe4816a2,
title = "Assessing the cost-effectiveness of RT Prepare: A radiation therapist-delivered intervention for reducing psychological distress prior to radiotherapy",
abstract = "Objective To determine the cost-effectiveness of RT Prepare in reducing breast cancer patients' psychological distress before treatment, compared with usual care. Methods RT Prepare, an intervention involving patient education and support consultations with a radiation therapist (RT), was implemented at three Australian sites (Australian New Zealand Clinical Trials Registration: ACTRN12611001000998). The primary outcome was change in psychological distress using the Hospital Anxiety and Depression Scale (HADS); secondary outcomes were changes in quality of life (QoL) and additional health service use. Costs (2015 $AU) included consultation time and training delivery. Between-group comparisons of HADS and QoL used generalised linear mixed models, and comparisons of health service use used negative binomial regression. Incremental cost-effectiveness ratios (ICERs) indicated mean costs per 1-point decrease in HADS score. Sensitivity analyses explored variation in facility size and uncertainty in intervention effectiveness. Results Among 218 controls and 189 intervention participants, the intervention significantly lowered HADS scores at treatment commencement (adjusted mean difference 1.06 points). There was no significant effect on QoL or additional service use. Mean intervention costs were AU$171 per participant (US$130, euro119) mostly related to RT training (approximately AU$142 (US$108, euro99). An ICER of $158 (US$120, euro110) was estimated. Cost-effectiveness improved in a sensitivity analysis representing a large facility with higher patient numbers. Conclusion This study provides new data on the cost-effectiveness of an RT-delivered intervention to reduce psychological distress prior to treatment, which will be useful to inform delivery of similar services. As most costs were upfront, cost-effectiveness would likely improve if implemented as standard care.",
keywords = "anxiety, breast cancer, cost-effectiveness, distress, radiation therapy, BREAST-CANCER PATIENTS, LED EDUCATIONAL INTERVENTION, QUALITY-OF-LIFE, ECONOMIC-EVALUATION, INFORMATION NEEDS, DEPRESSION, ANXIETY, CARE, PROVISION, COUNTRIES",
author = "{RT Prepare Project Team} and David Youens and Georgia Halkett and Cameron Wright and Moira O'Connor and Penelope Schofield and Michael Jefford and Sanchia Aranda and Robert Kane and Rachael Moorin",
year = "2019",
month = "5",
doi = "10.1002/pon.5065",
language = "English",
volume = "28",
pages = "1110--1118",
journal = "Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer",
issn = "1057-9249",
publisher = "John Wiley & Sons",
number = "5",

}

Assessing the cost-effectiveness of RT Prepare : A radiation therapist-delivered intervention for reducing psychological distress prior to radiotherapy. / RT Prepare Project Team.

In: Psycho-Oncology, Vol. 28, No. 5, 05.2019, p. 1110-1118.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Assessing the cost-effectiveness of RT Prepare

T2 - A radiation therapist-delivered intervention for reducing psychological distress prior to radiotherapy

AU - RT Prepare Project Team

AU - Youens, David

AU - Halkett, Georgia

AU - Wright, Cameron

AU - O'Connor, Moira

AU - Schofield, Penelope

AU - Jefford, Michael

AU - Aranda, Sanchia

AU - Kane, Robert

AU - Moorin, Rachael

PY - 2019/5

Y1 - 2019/5

N2 - Objective To determine the cost-effectiveness of RT Prepare in reducing breast cancer patients' psychological distress before treatment, compared with usual care. Methods RT Prepare, an intervention involving patient education and support consultations with a radiation therapist (RT), was implemented at three Australian sites (Australian New Zealand Clinical Trials Registration: ACTRN12611001000998). The primary outcome was change in psychological distress using the Hospital Anxiety and Depression Scale (HADS); secondary outcomes were changes in quality of life (QoL) and additional health service use. Costs (2015 $AU) included consultation time and training delivery. Between-group comparisons of HADS and QoL used generalised linear mixed models, and comparisons of health service use used negative binomial regression. Incremental cost-effectiveness ratios (ICERs) indicated mean costs per 1-point decrease in HADS score. Sensitivity analyses explored variation in facility size and uncertainty in intervention effectiveness. Results Among 218 controls and 189 intervention participants, the intervention significantly lowered HADS scores at treatment commencement (adjusted mean difference 1.06 points). There was no significant effect on QoL or additional service use. Mean intervention costs were AU$171 per participant (US$130, euro119) mostly related to RT training (approximately AU$142 (US$108, euro99). An ICER of $158 (US$120, euro110) was estimated. Cost-effectiveness improved in a sensitivity analysis representing a large facility with higher patient numbers. Conclusion This study provides new data on the cost-effectiveness of an RT-delivered intervention to reduce psychological distress prior to treatment, which will be useful to inform delivery of similar services. As most costs were upfront, cost-effectiveness would likely improve if implemented as standard care.

AB - Objective To determine the cost-effectiveness of RT Prepare in reducing breast cancer patients' psychological distress before treatment, compared with usual care. Methods RT Prepare, an intervention involving patient education and support consultations with a radiation therapist (RT), was implemented at three Australian sites (Australian New Zealand Clinical Trials Registration: ACTRN12611001000998). The primary outcome was change in psychological distress using the Hospital Anxiety and Depression Scale (HADS); secondary outcomes were changes in quality of life (QoL) and additional health service use. Costs (2015 $AU) included consultation time and training delivery. Between-group comparisons of HADS and QoL used generalised linear mixed models, and comparisons of health service use used negative binomial regression. Incremental cost-effectiveness ratios (ICERs) indicated mean costs per 1-point decrease in HADS score. Sensitivity analyses explored variation in facility size and uncertainty in intervention effectiveness. Results Among 218 controls and 189 intervention participants, the intervention significantly lowered HADS scores at treatment commencement (adjusted mean difference 1.06 points). There was no significant effect on QoL or additional service use. Mean intervention costs were AU$171 per participant (US$130, euro119) mostly related to RT training (approximately AU$142 (US$108, euro99). An ICER of $158 (US$120, euro110) was estimated. Cost-effectiveness improved in a sensitivity analysis representing a large facility with higher patient numbers. Conclusion This study provides new data on the cost-effectiveness of an RT-delivered intervention to reduce psychological distress prior to treatment, which will be useful to inform delivery of similar services. As most costs were upfront, cost-effectiveness would likely improve if implemented as standard care.

KW - anxiety

KW - breast cancer

KW - cost-effectiveness

KW - distress

KW - radiation therapy

KW - BREAST-CANCER PATIENTS

KW - LED EDUCATIONAL INTERVENTION

KW - QUALITY-OF-LIFE

KW - ECONOMIC-EVALUATION

KW - INFORMATION NEEDS

KW - DEPRESSION

KW - ANXIETY

KW - CARE

KW - PROVISION

KW - COUNTRIES

U2 - 10.1002/pon.5065

DO - 10.1002/pon.5065

M3 - Article

VL - 28

SP - 1110

EP - 1118

JO - Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer

JF - Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer

SN - 1057-9249

IS - 5

ER -