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Title: | Economic evaluation of the Very Early Rehabilitation in SpEech (VERSE) intervention. | Authors: | Kim J.;Sookram G.;Godecke E.;Brogan E.;Armstrong E.;Ellery F.;Rai T.;Rose M.L.;Ciccone N.;Middleton S.;Holland A.;Hankey G.J.;Bernhardt J.;Cadilhac D.A. | Monash Health Department(s): | Monash University - School of Clinical Sciences at Monash Health | Institution: | (Kim, Cadilhac) Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia (Kim, Ellery, Bernhardt, Cadilhac) Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (Sookram) Health Economics Unit, Australian Institute of Health and Welfare, Canberra, Australia (Godecke, Brogan, Armstrong, Ciccone) School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia (Godecke, Brogan) Speech Pathology Department, Sir Charles Gairdner Hospital, Perth, Australia (Rai) School of Mathematical and Physical Sciences, University of Technology NSW, Broadway, Australia (Rose) School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia (Middleton) Nursing Research Institute, Australian Catholic University, Darlinghurst, Australia (Holland) University of Arizona, Tucson, AZ, United States (Hankey) Medical School, University of Western Australia, Perth, Australia (Hankey) Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, Australia |
Issue Date: | 12-Jul-2023 | Copyright year: | 2023 | Publisher: | NLM (Medline) | Place of publication: | United Kingdom | Publication information: | Topics in Stroke Rehabilitation. 31(2) (pp 157-166), 2024. Date of Publication: 2024. | Journal: | Topics in Stroke Rehabilitation | Abstract: | INTRODUCTION: There is limited evidence on the costs and outcomes of patients with aphasia after stroke. The aim of this study was to estimate costs in patients with aphasia after stroke according to the aphasia therapies provided. METHOD(S): A three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment trial conducted in Australia and New Zealand. Usual ward-based care (Usual Care) was compared to additional usual ward-based therapy (Usual Care Plus) and a prescribed and structured aphasia therapy program in addition to Usual Care (the VERSE intervention). Information about healthcare utilization and productivity were collected to estimate costs in Australian dollars for 2017-18. Multivariable regression models with bootstrapping were used to estimate differences in costs and outcomes (clinically meaningful change in aphasia severity measured by the WAB-R-AQ). RESULT(S): Overall, 202/246 (82%) participants completed follow-up at 26 weeks. Median costs per person were $23,322 (Q1 5,367, Q3 52,669, n=63) for Usual Care, $26,923 (Q1 7,303, Q3 76,174, n=70) for Usual Care Plus and $31,143 (Q1 7,001. Q3 62,390, n=69) for VERSE. No differences in costs and outcomes were detected between groups. Usual Care Plus was inferior (i.e. more costly and less effective) in 64% of iterations, and in 18% was less costly and less effective compared to Usual Care. VERSE was inferior in 65% of samples and less costly and less effective in 12% compared to Usual Care. CONCLUSION(S): There was limited evidence that additional intensively delivered aphasia therapy within the context of usual acute care provided was worthwhile in terms of costs for the outcomes gained. | DOI: | http://monash.idm.oclc.org/login?url=https://dx.doi.org/10.1080/10749357.2023.2229039 | PubMed URL: | 37415422 [https://www.ncbi.nlm.nih.gov/pubmed/?term=37415422] | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/49952 | Type: | Article | Subjects: | aphasia cerebrovascular accident rehabilitation speech speech therapy |
Type of Clinical Study or Trial: | Randomised controlled trial |
Appears in Collections: | Articles |
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