Evidence map›Paper›PMID 38961340›Full record

Trial reportBMC primary care2024

Cost-effectiveness analysis of health tapestry, a complex primary care program for older adults: a post-hoc analysis.

J E Tarride, G Blackhouse, L Lamarche, P Forsyth, D Oliver, T Carr, M Howard, L Thabane, J Datta, L Dolovich and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC primary care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

J E TarrideDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. tarride@mcmaster.ca.
G BlackhouseDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
L LamarcheDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
P ForsythDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
D OliverDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
T CarrDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
M HowardDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
L ThabaneDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
J DattaDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
L DolovichDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
R ClarkDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
D PriceDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
D ManginDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe initially reported on the cost-effectiveness of a 6-month randomized controlled implementation trial which evaluated Health TAPESTRY, a primary care program for older adults, at the McMaster Family Health Team (FHT) site and 5 other FHT sites in Ontario, Canada. While there were no statistically significant between-group differences in outcomes at month 6 post randomization, positive outcomes were observed at the McMaster FHT site, which recruited 40% (204/512) of the participants. The objective of this post-hoc study was to determine the cost-effectiveness of Health TAPESTRY based on data from the McMaster FHT site.

methodsCosts included the cost to implement Health TAPESTRY at McMaster as well as healthcare resource consumed, which were costed using publicly available sources. Health-related-quality-of-life was evaluated with the EQ-5L-5L at baseline and at month 6 post randomization. Quality-adjusted-life-years (QALYs) were calculated under an-area-under the curve approach. Unadjusted and adjusted regression analyses (two independent regression analyses on costs and QALYs, seemingly unrelated regression [SUR], net benefit regression) as well as difference-in-difference and propensity score matching (PSM) methods, were used to deal with the non-randomized nature of the trial. Sampling uncertainty inherent to the trial data was estimated using non-parametric bootstrapping. The return on investment (ROI) associated with Health TAPESTRY was calculated. All costs were reported in 2021 Canadian dollars.

resultsWith an intervention cost of $293/patient, Health TAPESTRY was the preferred strategy in the unadjusted and adjusted analyses. The results of our bootstrap analyses indicated that Health TAPESTRY was cost-effective compared to usual care at commonly accepted WTP thresholds. For example, if decision makers were willing to pay $50,000 per QALY gained, the probability of Health TAPESTRY to be cost effective compared to usual care varied from 0.72 (unadjusted analysis) to 0.96 (SUR) when using a WTP of $50,000/QALY gained. The DID and ROI analyses indicated that Health Tapestry generated a positive ROI.

conclusionHealth TAPESTRY was the preferred strategy when implemented at the McMaster FHT. We caution care in interpreting the results because of the post-hoc nature of the analyses and limited sample size based on one site.

Indexed as

Primary Health CareQuality-Adjusted Life YearsAgedAged, 80 and overCost-Effectiveness AnalysisFemaleHumansMaleOntarioQuality of LifeCost-EffectivenessElder CareFamily Health TeamHealth TAPESTRYVolunteers

Identifiers

PMID38961340
PMCPMC11223344

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.