Estimating the cost consequence of the early use of botulinum toxin in post-stroke spasticity: Secondary analysis of a randomised controlled trial

Authors: Lindsay, C., Humphreys, I., Phillips, C. and Pandyan, A.

Journal: Clinical Rehabilitation

Volume: 37

Issue: 3

Pages: 373-380

eISSN: 1477-0873

ISSN: 0269-2155

DOI: 10.1177/02692155221133522

Abstract:

Objective: To estimate the cost-consequence of treating spasticity early with botulinum toxin in the acute stroke unit. Design: Secondary cost-consequence analysis, using data from a double-blind randomised-controlled trial. Setting: Single-centre specialised stroke unit. Subjects and Interventions: Patients with Action Research Arm Test grasp-score of <2 and who developed spasticity within six weeks of a first stroke were randomised to receive injections of: 0.9% sodium-chloride solution (placebo) or onabotulinumtoxin-A (treatment). Main measures: Resource use costs were calculated for the study. Mean contracture costs for each group were calculated. The Barthel Index and Action Research Arm Test were used to generate a cost per unit of improvement. Results: There were no significant differences associated with early treatment use. The mean contracture cost for the treatment group was £817 and for the control group was £2298 (mean difference = −£1481.1(95% CI −£2893.5, −£68.7) (p = 0.04). The cost per unit of improvement for the Barthel Index was −£1240 indicating that the intervention costs less and is more effective. The cost per unit of improvement for the Action Research Arm Test was −£450 indicating that the intervention costs less and is more effective. Conclusions: Treating spasticity early in stroke patients at risk of contractures with botulinum toxin leads to a significant reduction in contracture costs. The cost per improvement of Barthel and Action Research Arm Test indicates that the intervention costs less and is more effective. Trial Registration data: EudraCT(2010-021257-39) and ClinicalTrials.gov-Identifier:NCT01882556.

https://eprints.bournemouth.ac.uk/37800/

Source: Scopus

Estimating the cost consequence of the early use of botulinum toxin in post-stroke spasticity: Secondary analysis of a randomised controlled trial.

Authors: Lindsay, C., Humphreys, I., Phillips, C. and Pandyan, A.

Journal: Clin Rehabil

Volume: 37

Issue: 3

Pages: 373-380

eISSN: 1477-0873

DOI: 10.1177/02692155221133522

Abstract:

OBJECTIVE: To estimate the cost-consequence of treating spasticity early with botulinum toxin in the acute stroke unit. DESIGN: Secondary cost-consequence analysis, using data from a double-blind randomised-controlled trial. SETTING: Single-centre specialised stroke unit. SUBJECTS AND INTERVENTIONS: Patients with Action Research Arm Test grasp-score of <2 and who developed spasticity within six weeks of a first stroke were randomised to receive injections of: 0.9% sodium-chloride solution (placebo) or onabotulinumtoxin-A (treatment). MAIN MEASURES: Resource use costs were calculated for the study. Mean contracture costs for each group were calculated. The Barthel Index and Action Research Arm Test were used to generate a cost per unit of improvement. RESULTS: There were no significant differences associated with early treatment use. The mean contracture cost for the treatment group was £817 and for the control group was £2298 (mean difference = -£1481.1(95% CI -£2893.5, -£68.7) (p = 0.04). The cost per unit of improvement for the Barthel Index was -£1240 indicating that the intervention costs less and is more effective. The cost per unit of improvement for the Action Research Arm Test was -£450 indicating that the intervention costs less and is more effective. CONCLUSIONS: Treating spasticity early in stroke patients at risk of contractures with botulinum toxin leads to a significant reduction in contracture costs. The cost per improvement of Barthel and Action Research Arm Test indicates that the intervention costs less and is more effective. TRIAL REGISTRATION DATA: EudraCT(2010-021257-39) and ClinicalTrials.gov-Identifier:NCT01882556.

https://eprints.bournemouth.ac.uk/37800/

Source: PubMed

Estimating the cost consequence of the early use of botulinum toxin in post-stroke spasticity: Secondary analysis of a randomised controlled trial

Authors: Lindsay, C., Humphreys, I., Phillips, C. and Pandyan, A.

Journal: CLINICAL REHABILITATION

Volume: 37

Issue: 3

Pages: 373-380

eISSN: 1477-0873

ISSN: 0269-2155

DOI: 10.1177/02692155221133522

https://eprints.bournemouth.ac.uk/37800/

Source: Web of Science (Lite)

Estimating the cost consequence of the early use of botulinum toxin in post-stroke spasticity: Secondary analysis of a randomised controlled trial.

Authors: Lindsay, C., Humphreys, I., Phillips, C. and Pandyan, A.

Journal: Clinical rehabilitation

Volume: 37

Issue: 3

Pages: 373-380

eISSN: 1477-0873

ISSN: 0269-2155

DOI: 10.1177/02692155221133522

Abstract:

Objective

To estimate the cost-consequence of treating spasticity early with botulinum toxin in the acute stroke unit.

Design

Secondary cost-consequence analysis, using data from a double-blind randomised-controlled trial.

Setting

Single-centre specialised stroke unit.

Subjects and interventions

Patients with Action Research Arm Test grasp-score of <2 and who developed spasticity within six weeks of a first stroke were randomised to receive injections of: 0.9% sodium-chloride solution (placebo) or onabotulinumtoxin-A (treatment).

Main measures

Resource use costs were calculated for the study. Mean contracture costs for each group were calculated. The Barthel Index and Action Research Arm Test were used to generate a cost per unit of improvement.

Results

There were no significant differences associated with early treatment use. The mean contracture cost for the treatment group was £817 and for the control group was £2298 (mean difference = -£1481.1(95% CI -£2893.5, -£68.7) (p = 0.04). The cost per unit of improvement for the Barthel Index was -£1240 indicating that the intervention costs less and is more effective. The cost per unit of improvement for the Action Research Arm Test was -£450 indicating that the intervention costs less and is more effective.

Conclusions

Treating spasticity early in stroke patients at risk of contractures with botulinum toxin leads to a significant reduction in contracture costs. The cost per improvement of Barthel and Action Research Arm Test indicates that the intervention costs less and is more effective.

Trial registration data

EudraCT(2010-021257-39) and ClinicalTrials.gov-Identifier:NCT01882556.

https://eprints.bournemouth.ac.uk/37800/

Source: Europe PubMed Central

Estimating the cost consequence of the early use of botulinum toxin in post-stroke spasticity: Secondary analysis of a randomised controlled trial.

Authors: Lindsay, C., Humphreys, I., Phillips, C. and Pandyan, A.

Journal: Clinical Rehabilitation

Volume: 37

Issue: 3

Pages: 373-380

ISSN: 0269-2155

Abstract:

OBJECTIVE: To estimate the cost-consequence of treating spasticity early with botulinum toxin in the acute stroke unit. DESIGN: Secondary cost-consequence analysis, using data from a double-blind randomised-controlled trial. SETTING: Single-centre specialised stroke unit. SUBJECTS AND INTERVENTIONS: Patients with Action Research Arm Test grasp-score of <2 and who developed spasticity within six weeks of a first stroke were randomised to receive injections of: 0.9% sodium-chloride solution (placebo) or onabotulinumtoxin-A (treatment). MAIN MEASURES: Resource use costs were calculated for the study. Mean contracture costs for each group were calculated. The Barthel Index and Action Research Arm Test were used to generate a cost per unit of improvement. RESULTS: There were no significant differences associated with early treatment use. The mean contracture cost for the treatment group was £817 and for the control group was £2298 (mean difference = -£1481.1(95% CI -£2893.5, -£68.7) (p = 0.04). The cost per unit of improvement for the Barthel Index was -£1240 indicating that the intervention costs less and is more effective. The cost per unit of improvement for the Action Research Arm Test was -£450 indicating that the intervention costs less and is more effective. CONCLUSIONS: Treating spasticity early in stroke patients at risk of contractures with botulinum toxin leads to a significant reduction in contracture costs. The cost per improvement of Barthel and Action Research Arm Test indicates that the intervention costs less and is more effective. TRIAL REGISTRATION DATA: EudraCT(2010-021257-39) and ClinicalTrials.gov-Identifier:NCT01882556.

https://eprints.bournemouth.ac.uk/37800/

Source: BURO EPrints