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Training care givers of stroke patients: economic evaluation

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7448.1102 (Published 06 May 2004) Cite this as: BMJ 2004;328:1102
  1. Anita Patel, lecturer in health economics1,
  2. Martin Knapp, professor of health economics1,
  3. Andrew Evans, clinical lecturer in stroke medicine2,
  4. Inigo Perez, research fellow2,
  5. Lalit Kalra, professor of stroke medicine (lalit.kalra{at}kcl.ac.uk)2
  1. 1Centre for the Economics of Mental Health, Institute of Psychiatry, London SE5 8AF
  2. 2Department of Medicine, Guy's, King's and St Thomas's School of Medicine, London SE5 9PJ
  1. Correspondence to: L Kalra
  • Accepted 5 March 2004

Abstract

Background Training care givers reduces their burden and improves psychosocial outcomes in care givers and patients at one year. However, the cost effectiveness of this approach has not been investigated.

Objective To evaluate the cost effectiveness of caregiver training by examining health and social care costs, informal care costs, and quality adjusted life years in care givers.

Design A single, blind, randomised controlled trial.

Setting Stroke rehabilitation unit.

Subjects 300 stroke patients and their care givers.

Interventions Caregiver training in basic nursing and facilitation of personal care techniques compared with no caregiver training.

Main outcome measures Health and social care costs, informal care costs, and quality adjusted life years in care givers over one year after stroke.

Results Total health and social care costs over one year for patients whose care givers received training were significantly lower (mean difference -£4043 ($7249; €, 95% confidence interval -£6544 to -£1595). Inclusion of informal care costs, which were similar between the two groups, did not alter this conclusion. The cost difference was largely due to differences in length of hospital stay. The EQ-5D did not detect changes in quality adjusted life years in care givers.

Conclusion Compared with no training, caregiver training during rehabilitation of patients reduced costs of care while improving overall quality of life in care givers at one year.

Footnotes

  • Contributors AP was responsible for the analysis and interpretation of the data and drafting of the paper. MK was involved in the conception and design of the study, interpretation of data and writing of the paper. LK was responsible for the conception, design, initiation, and overall coordination of the study, interpretation of data and drafting of the paper. AE was responsible for collation of data and critical review of the paper. IP was involved in the design of the study, day to day administration of the study, data collection, and data entry. LK will act as the guarantor of the paper on behalf of all investigators.

  • Funding The project was funded by the NHS R&D Executive's Primary Secondary Interface Priority Programme (Project No: F-4/1997).

  • Conflict of interest None.

  • Ethical approval Bromley Research Ethics Committee (LREC/106).

  • Accepted 5 March 2004
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