Cost-effectiveness of a nurse-led education and psychosocial programme for patients with chronic heart failure and their partners

Authors

  • Susanna Ågren,

    1. Authors: Susanna Ågren, RN, PhD, Adjunct Lecturer in Thoracic and Vascular Nursing, Department of Medicine and Health Sciences, Linköping University, Division of Nursing Sciences, Linköping University, Linköping and Department of Medicine and Health Sciences, Linköping University, Department of Cardiothoracic Surgery, County Council of Östergötland, Linköping, Sweden; Lorraine S Evangelista, PhD, RN, FAHA, FAAN, Associate Professor, UC Irvine Program of Nursing Science, Irvine, CA, USA; Thomas Davidson, PhD, Health Economist, Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University, Linköping; Anna Strömberg, RN, PhD, Professor, Department of Medicine and Health Sciences, Linköping University, Department of Cardiology, County Council of Östergötland, Linköping, Sweden
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  • Lorraine S Evangelista,

    1. Authors: Susanna Ågren, RN, PhD, Adjunct Lecturer in Thoracic and Vascular Nursing, Department of Medicine and Health Sciences, Linköping University, Division of Nursing Sciences, Linköping University, Linköping and Department of Medicine and Health Sciences, Linköping University, Department of Cardiothoracic Surgery, County Council of Östergötland, Linköping, Sweden; Lorraine S Evangelista, PhD, RN, FAHA, FAAN, Associate Professor, UC Irvine Program of Nursing Science, Irvine, CA, USA; Thomas Davidson, PhD, Health Economist, Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University, Linköping; Anna Strömberg, RN, PhD, Professor, Department of Medicine and Health Sciences, Linköping University, Department of Cardiology, County Council of Östergötland, Linköping, Sweden
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  • Thomas Davidson,

    1. Authors: Susanna Ågren, RN, PhD, Adjunct Lecturer in Thoracic and Vascular Nursing, Department of Medicine and Health Sciences, Linköping University, Division of Nursing Sciences, Linköping University, Linköping and Department of Medicine and Health Sciences, Linköping University, Department of Cardiothoracic Surgery, County Council of Östergötland, Linköping, Sweden; Lorraine S Evangelista, PhD, RN, FAHA, FAAN, Associate Professor, UC Irvine Program of Nursing Science, Irvine, CA, USA; Thomas Davidson, PhD, Health Economist, Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University, Linköping; Anna Strömberg, RN, PhD, Professor, Department of Medicine and Health Sciences, Linköping University, Department of Cardiology, County Council of Östergötland, Linköping, Sweden
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  • Anna Strömberg

    1. Authors: Susanna Ågren, RN, PhD, Adjunct Lecturer in Thoracic and Vascular Nursing, Department of Medicine and Health Sciences, Linköping University, Division of Nursing Sciences, Linköping University, Linköping and Department of Medicine and Health Sciences, Linköping University, Department of Cardiothoracic Surgery, County Council of Östergötland, Linköping, Sweden; Lorraine S Evangelista, PhD, RN, FAHA, FAAN, Associate Professor, UC Irvine Program of Nursing Science, Irvine, CA, USA; Thomas Davidson, PhD, Health Economist, Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University, Linköping; Anna Strömberg, RN, PhD, Professor, Department of Medicine and Health Sciences, Linköping University, Department of Cardiology, County Council of Östergötland, Linköping, Sweden
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Susanna Ågren, Adjunct Lecturer in Thoracic and Vascular Nursing, Department of Medicine and Health Sciences, Linkäping University, Division of Nursing Sciences, Linköping University, Linköping, Sweden. Telephone: +46 10 37759.
E-mail: susanna.agren@liu.se

Abstract

Aims and objectives.  This randomised controlled trial was conducted to estimate the cost-effectiveness of a nurse-led education and psychosocial support programme for patients with heart failure (HF) and their partners.

Background.  There are few studies evaluating cost-effectiveness of interventions among HF patient–partner dyads.

Methods.  Dyads randomised to the experimental group received nurse-led counselling, computer-based education and written materials aimed at developing problem-solving skills at two, six and 12 weeks after hospitalisation with HF exacerbation. The dyads in the control group received usual care. A cost-effectiveness analysis that included costs associated with staff time to deliver the intervention and travel costs was conducted at 12 months. Quality-adjusted life-year (QALY) weights for patients and partners were estimated by SF-6D.

Results.  A total of 155 dyads were included. The intervention cost was €223 per patient. Participants in both groups showed improvements in QALY weights after 12 months. However, no significant difference in QALY weights was found between the patients in the two groups, nor among their partners.

Conclusion.  The intervention was not proven cost-effective, neither for patients nor for partners. The intervention, however, had trends (but not significant) effects on the patient–partner dyads, and by analysing the QALY gained from the dyad, a reasonable mean cost-effectiveness ratio was achieved.

Relevance to clinical practice.  The study shows trends of a cost-effective education and psychosocial care of HF patient–partner dyads.

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