학술논문

Cost-effectiveness of a 3-month intervention with oral nutritional supplements in disease-related malnutrition: a randomised controlled pilot study.
Document Type
Article
Source
European Journal of Clinical Nutrition. Jun2011, Vol. 65 Issue 6, p735-742. 8p.
Subject
*MALNUTRITION
*DIETARY supplements
*COST effectiveness
*RANDOMIZED controlled trials
*NUTRITION counseling
*HEALTH care intervention (Social services)
*QUALITY of life
Language
ISSN
0954-3007
Abstract
Background/Objectives:Nutritional intervention with oral nutritional supplements (ONS) has been shown to increase quality of life in malnourished patients. We investigated whether post-hospital supplementation with ONS is cost-effective according to international benchmarks in malnourished patients.Subjects/Methods:In total, 114 malnourished patients (50.6±16.1 years, 57 female) with benign gastrointestinal disease were included and randomised to receive either ONS for 3 months and dietary counselling at discharge (intervention, n=60) or only dietary counselling at discharge (control group, n=54). Nutritional status was assessed with Subjective Global Assessment. Intervention patients documented daily intake of ONS; quality of life was assessed with Short-Form (SF)-36 Health Survey and SF-36 values were transformed into health-status utilities. Quality-adjusted life years (QALYs) were calculated by adopting the area under the curve method. We used two different pricing scenarios for ONS (minimum price: \[euro]2.30 and maximum: \[euro]2.93/tetrapack). The incremental cost-effectiveness ratio (ICER) of supplementation with ONS was calculated for both price scenarios. All analyses were corrected for age and gender.Results:Intervention patients consumed 2.4±0.8 ONS per day. Intervention and control patients did not differ in their health status utilities at baseline (0.594±0.017 vs 0.619±0.018), but after 3 months, the health status utilities were significantly higher in intervention patients than in control patients (0.731±0.015 vs 0.671±0.016, P=0.028). Intervention was associated with significantly higher costs (ICER: \[euro]9497 and \[euro]12 099/additional QALY, respectively) but deemed cost-effective according to international thresholds (<\[euro]50 000/QALY).Conclusions:A 3-month intervention with ONS increases quality of life in malnourished patients. This treatment appears to be cost-effective according to international benchmarks. [ABSTRACT FROM AUTHOR]