Gastroenterologist and nurse management of symptoms after pelvic radiotherapy for cancer: an economic evaluation of a clinical randomized controlled trial (the ORBIT study)

ClinicoEconomics and Outcomes Research : CEOR
Jake JordanH Jervoise N Andreyev

Abstract

Over 20 distressing gastrointestinal symptoms affect many patients after pelvic radiotherapy, but in the United Kingdom few are referred for assessment. Algorithmic-based treatment delivered by either a consultant gastroenterologist or a clinical nurse specialist has been shown in a randomized trial to be statistically and clinically more effective than provision of a self-help booklet. In this study, we assessed cost-effectiveness. Outcomes were measured at baseline (pre-randomization) and 6 months. Change in quality-adjusted life years (QALYs) was the primary outcome for the economic evaluation; a secondary analysis used change in the bowel subset score of the modified Inflammatory Bowel Disease Questionnaire (IBDQ-B). Intervention costs, British pounds 2013, covered visits with the gastroenterologist or nurse, investigations, medications and treatments. Incremental outcomes and incremental costs were estimated simultaneously using multivariate linear regression. Uncertainty was handled non-parametrically using bootstrap with replacement. The mean (SD) cost of treatment was £895 (499) for the nurse and £1101 (567) for the consultant. The nurse was dominated by usual care, which was cheaper and achieved better outcomes. The me...Continue Reading

Citations

Mar 19, 2019·Current Opinion in Supportive and Palliative Care·Andrea M Stringer, Nicole Blijlevens
Jan 28, 2021·European Journal of Cancer Care·Helen KerrOonagh McSorley
Dec 1, 2021·Acta Oncologica·Susanne HaasPeter Christensen

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Clinical Trials Mentioned

NCT00737230

Software Mentioned

ORBIT
IBDQ
STATA13

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