TY - JOUR
T1 - Cost effectiveness of guideline advice for children with asthma
T2 - A literature review
AU - Feenstra, Talitha L.
AU - Rutten-van Mölken, Maureen P.M.H.
AU - Jager, Johannes C.
AU - Van Essen-Zandvliet, Liesbeth E.M.
N1 - This article is based on the report “Guidelines and Cost Effectiveness for the Long-Term Treatment of Children With Asthma” by T.L. Feenstra, J.C. Jager, and M.P.M.H. Rutten-van Mölken, RIVM report no. 403505.002, Bilthoven, The Netherlands, National Institute of Public Health and the Environment RIVM, 1999
PY - 2002/12
Y1 - 2002/12
N2 - Asthma is an important chronic disease among children. This study reviews the cost effectiveness of interventions in the long-term care of asthmatic children and compares these results with treatment advice in four current guidelines. Cost-effectiveness studies were searched for in Medline, Embase, Healthstar, Biosis, and the Office of Health Economics-Health Economic Evaluations Database (OHE-HEED), and the Cochrane Library was searched for meta-analyses of clinical trials. In the four reviewed guidelines, cost effectiveness is not explicitly used as a criterion. The cost-effectiveness studies show sufficient evidence for the cost effectiveness of treatment with inhaled steroids and for self-management programs for severe asthmatic patients. Inclusion of these results in the guidelines would not lead to significant changes in current treatment advice. The effectiveness of various measures for trigger avoidance is not fully proven, and hence neither is their cost effectiveness. Available information on the cost effectiveness of cromolyn could be used to focus the guidelines. Finally, evidence exists that organizational interventions, e.g., the employment of asthma nurses, can result in cost savings, but it is unclear to what extent these results can be generalized. More cost-effectiveness studies are needed, especially on long-acting bronchodilators and self-management programs for mild and moderate asthma, in order to help make the guidelines more informative and reduce the differences between them.
AB - Asthma is an important chronic disease among children. This study reviews the cost effectiveness of interventions in the long-term care of asthmatic children and compares these results with treatment advice in four current guidelines. Cost-effectiveness studies were searched for in Medline, Embase, Healthstar, Biosis, and the Office of Health Economics-Health Economic Evaluations Database (OHE-HEED), and the Cochrane Library was searched for meta-analyses of clinical trials. In the four reviewed guidelines, cost effectiveness is not explicitly used as a criterion. The cost-effectiveness studies show sufficient evidence for the cost effectiveness of treatment with inhaled steroids and for self-management programs for severe asthmatic patients. Inclusion of these results in the guidelines would not lead to significant changes in current treatment advice. The effectiveness of various measures for trigger avoidance is not fully proven, and hence neither is their cost effectiveness. Available information on the cost effectiveness of cromolyn could be used to focus the guidelines. Finally, evidence exists that organizational interventions, e.g., the employment of asthma nurses, can result in cost savings, but it is unclear to what extent these results can be generalized. More cost-effectiveness studies are needed, especially on long-acting bronchodilators and self-management programs for mild and moderate asthma, in order to help make the guidelines more informative and reduce the differences between them.
UR - http://www.scopus.com/inward/record.url?scp=0036891497&partnerID=8YFLogxK
U2 - 10.1002/ppul.10177
DO - 10.1002/ppul.10177
M3 - Article
C2 - 12422342
AN - SCOPUS:0036891497
SN - 8755-6863
VL - 34
SP - 442
EP - 454
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
IS - 6
ER -