Document Detail


Cost-effectiveness of nutritional intervention in elderly subjects after hip fracture. A randomized controlled trial.
MedLine Citation:
PMID:  22638708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Previous research on the effect of nutritional intervention on clinical outcome in hip fracture patients yielded contradictory results. Cost-effectiveness of nutritional intervention in these patients remains unknown. The aim of this study was to evaluate cost-effectiveness of nutritional intervention in elderly subjects after hip fracture from a societal perspective.
METHODS: Open-label, multi-centre randomized controlled trial investigating cost-effectiveness of intensive nutritional intervention comprising regular dietetic counseling and oral nutritional supplementation for 3 months postoperatively. Patients allocated to the control group received care as usual. Costs, weight and quality of life were measured at baseline and at 3 and 6 months postoperatively. Incremental cost-effectiveness ratios (ICERs) were calculated for weight at 3 months and quality adjusted life years (QALYs) at 6 months postoperatively.
RESULTS: Of 152 patients enrolled, 73 were randomized to the intervention group and 79 to the control group. Mean costs of the nutritional intervention was 613 Euro. Total costs and subcategories of costs were not significantly different between both groups. Based on bootstrapping of ICERs, the nutritional intervention was likely to be cost-effective for weight as outcome over the 3-month intervention period, regardless of nutritional status at baseline. With QALYs as outcome, the probability for the nutritional intervention being cost-effective was relatively low, except in subjects aged below 75 years.
CONCLUSION: Intensive nutritional intervention in elderly hip fracture patients is likely to be cost-effective for weight but not for QALYs. Future cost-effectiveness studies should incorporate outcome measures appropriate for elderly patients, such as functional limitations and other relevant outcome parameters for elderly.
Authors:
C E Wyers; P L M Reijven; S M A A Evers; P C Willems; I C Heyligers; A D Verburg; S van Helden; P C Dagnelie
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-05-26
Journal Detail:
Title:  Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA     Volume:  24     ISSN:  1433-2965     ISO Abbreviation:  Osteoporos Int     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-04     Completed Date:  2013-06-10     Revised Date:  2013-06-24    
Medline Journal Info:
Nlm Unique ID:  9100105     Medline TA:  Osteoporos Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  151-62     Citation Subset:  IM    
Affiliation:
Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. caroline.wyers@maastrichtuniversity.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Body Weight
Cost-Benefit Analysis
Counseling / economics,  methods
Dietary Supplements / economics*
Elder Nutritional Physiological Phenomena / physiology*
Female
Fracture Fixation / rehabilitation
Health Care Costs / statistics & numerical data
Hip Fractures / economics,  rehabilitation*
Humans
Male
Middle Aged
Netherlands
Nutritional Support / economics,  methods
Postoperative Care / economics*,  methods
Quality-Adjusted Life Years
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