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|Effects of social support and education on health care costs for patients with fibromyalgia|
|Oliver K, Cronan TA, Walen HR, Tomita M|
|The Journal of Rheumatology 2001 Dec;28(12):2711-2719|
|5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
OBJECTIVE: The rising costs of health care are of great concern, particularly for the chronically ill. Interventions that promote health status and well being while teaching appropriate use of the health care system have led to cost savings among patients with osteoarthritis. We carried out social support and education interventions with patients with fibromyalgia (FM) and assessed the effect on health care costs, psychosocial variables, and health status. METHODS: Participants were 600 patients with FM who were members of a health maintenance organization. They were randomly assigned to one of 2 experimental groups (social support; social support and education) or to a no-treatment control group. Assessments were conducted at baseline and following a one year intervention. Health care cost data were obtained directly from participants' medical records. RESULTS: Results indicated significant reductions in all groups' costs of prescriptions, laboratory tests, and visits to a nurse, nurse practitioner and/or physicians' assistant. All groups also showed improvements on variables assessing effect of FM, self-efficacy, depression, and knowledge of FM. The social support and education group was less helpless after one year than the other groups; differential changes for all other variables were not significant. CONCLUSION: The study did not reveal differential changes in health care costs among participants in the experimental and control groups. These findings emphasize the importance of using objective health care utilization data when calculating health care costs, as well as the value of including a no-treatment control group to prevent erroneous conclusions about treatment efficacy.