Health Economics
This part of the trial is led by Professor Linda Davies, Professor of Health Economics. It has two main aims:
-
to determine the cost-effectiveness of the interventions provided
-
to explore preferences for different outcomes of communication therapy
Aim 1 - Cost Effectiveness
This is achieved through gathering information on the costs of communication therapy versus attention control. We take detailed information on how much the treatment costs, as well as what hospital services people in the two groups have used. These data are gathered using two methods:
-
via Carers - carers involved in the ACT NoW study will self-complete the ACT NoW 'Support for Others Questionnaire' to give an overview of what services have been received by the patient.
-
via medical records - Research Assistants will gather specific data on services / treatments accessed by ACT NoW patients through hospital records.
These costs will then be compared to the outcomes of patients to assess whether any additional benefits of the ACT NoW therapy intervention are worth the additional costs.
Target Population
All patients and carers involved in the main ACT NoW trial for whom we have outcomes data.
Aim 2 - Preferences for therapy outcomes
The ACT NoW study relates to communication therapy and may impact service delivery. It is clear that communication therapy comprises a complex intervention. There is a correspondingly complex set of outcomes. Therefore standard measures of clinical outcome, health status and value of gains in health related quality of life may be insufficient for the rigorous evaluation of communication therapy. It is important to be 'in touch' with a general view on what makes therapy successful. Patients and clinicians will contribute to this view and it also requires insight from potential service users i.e. the general public.
Method
We aim to determine preferences for communication therapy outcomes using a discrete choice experiment (DCE). DCEs provide an approach to identify people's preferences for the outcome and waiting times for communication therapy. The DCE method assumes that the total value a consumer attaches to a service is described by the sum of its individual characteristics. These characteristics can relate to the clinical outcome of a service (such as functional communication ability), the ability of a person to participate in aspects of daily life (such as social and family life or interests and hobbies), or the process of providing the service (such as waiting times for therapy). The ability to incorporate both outcome and process attributes is one of the key advantages of this method. The DCE is presented as a survey / questionnaire to participants.
Target Population
The target population for the DCE will comprise members of the public. They will be invited to participate in the questionnaire by postal invitation via postcodes randomly selected from the North West. They can return the questionnaire using the freepost envelope provided or by completing online. We need to receive 246 fully completed questionnaires. 3,000 copies of the questionnaire were sent to a random sample of address in January 2010. As of 23rd March, we have received 191 responses. We intend to send out another 1,000 questionnaires and also to encourage people to access an online version of the questionnaire for completion to boost our sample.
Dissemination
The information collected from all aspects of the Health Economics part of the study will be disseminated in a final report to NIHR Health Technology Assessment Programme and be published in the Health Technology Assessment Monograph Series. The results will also be published in appropriate peer reviewed journals and at peer reviewed meetings and conferences. A summary of the results will be provided on this website and you can keep up to date with current dissemination by checking our 'Study Outputs' pages or by clicking here.
