Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Cost-effectiveness of internet-based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice [with consumer summary]
van Vugt A, Bosmans JE, Finch AP, van der Wouden JC, van der Horst HE, Maarsingh OR
BMJ Open 2020 Oct;10(10):e035583
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; 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*

OBJECTIVES: To evaluate the cost-effectiveness of stand-alone and blended internet-based vestibular rehabilitation (VR) in comparison with usual care (UC) for chronic vestibular syndromes in general practice. DESIGN: Economic evaluation alongside a three-armed, individually randomised controlled trial. SETTING: 59 Dutch general practices. PARTICIPANTS: 322 adults, aged 50 years and older with a chronic vestibular syndrome. INTERVENTIONS: Stand-alone VR consisted of a 6-week, internet-based intervention with weekly online sessions and daily exercises. In blended VR, this intervention was supplemented with face-to-face physiotherapy support. UC group participants received usual general practice care without restrictions. MAIN OUTCOME MEASURES: Societal costs, quality-adjusted life years (QALYs), Vertigo Symptom Scale -- Short Form (VSS-SF), clinically relevant response (>= 3 points VSS-SF improvement). RESULTS: Mean societal costs in both the stand-alone and blended VR groups were statistically non-significantly higher than in the UC group (mean difference (MD) Euro 504, 95% CI -1,082 to 2,268; and Euro 916, 95% CI -663 to 2,596). Both stand-alone and blended VR groups reported non-significantly more QALYs than the UC group (MD 0.02, 95% CI -0.00 to 0.04; and 0.01, 95% CI -0.01 to 0.03), and significantly better VSS-SF scores (MD 3.8 points, 95% CI 1.7 to 6.0; and 3.3 points, 95% CI 1.3 to 5.2). For stand-alone VR compared with UC, the probability of cost-effectiveness was 0.95 at a willingness-to-pay ratio of Euro 24 161/QALY, Euro 600/point improvement in VSS-SF and Euro 8,000/clinically relevant responder in VSS-SF. For blended VR versus UC, the probability of cost-effectiveness was 0.95 at a willingness-to-pay ratio of Euro 123,335/QALY, Euro 900/point improvement in VSS-SF and Euro 24,000/clinically relevant responder in VSS-SF. CONCLUSION: Stand-alone and blended internet-based VR non-significantly increased QALYs and significantly reduced vestibular symptoms compared with UC, while costs in both groups were non-significantly higher. Stand-alone VR has the highest probability to be cost-effective compared with UC. TRIAL REGISTRATION NUMBER: The Netherlands Trial Register NTR5712.
Reproduced with permission from the BMJ Publishing Group.

Full text (sometimes free) may be available at these link(s):      help