Practice costs of implementing guidelines for asthma and angina: findings from a randomised controlled trial

Area of Science:

• Health economics
• Clinical practice improvement
• Respiratory and cardiovascular medicine

Background:

• Improving patient care for stable angina and asthma requires effective interventions.
• Understanding the economic implications of different care improvement strategies is crucial for healthcare resource allocation.

Purpose of the Study:

• To evaluate and compare the costs associated with three interventions aimed at enhancing the care of adults with stable angina or asthma.
• To determine the cost-effectiveness of disseminating full guidelines, prioritized review criteria, or criteria plus feedback.

Main Methods:

• A randomized controlled trial was used to collect cost data for three distinct interventions.
• Costs were analyzed per practice, considering disease type and intervention specifics.

Main Results:

• The intervention involving criteria with feedback incurred the highest cost at pound180 per practice.
• Disseminating full guidelines or prioritized review criteria cost between pound9.60 and pound31.45 per practice.
• Overall mean practice costs ranged from pound838 to pound2127, varying by disease and intervention.

Conclusions:

• The cost of implementing care improvement interventions differs significantly.
• Criteria with feedback represents a more resource-intensive approach compared to guideline dissemination or review criteria alone.
• Economic evaluation is essential for selecting optimal strategies in managing stable angina and asthma.