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dc.contributor.authorGillespie, Paddyen
dc.contributor.authorO'Shea, Eamonen
dc.contributor.authorMurphy, Andrew W.en
dc.contributor.authorByrne, Mary C.en
dc.contributor.authorByrne, Mollyen
dc.identifier.citationGillespie,P., O'Shea,E., Murphy, A. W., Byrne,M. C., Byrne, M. "The cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart disease" International Journal of Technology Assessment in Health Care (2010), 26: 263-271en
dc.description.abstractObjectives: The Secondary Prevention of Heart disEase in geneRal practicE (SPHERE) trial has recently reported. This study examines the cost-effectiveness of the SPHERE intervention in both healthcare systems on the island of Ireland. Methods: Incremental cost-effectiveness analysis. A probabilistic model was developed to combine within-trial and beyond-trial impacts of treatment to estimate the lifetime costs and benefits of two secondary prevention strategies: Intervention - tailored practice and patient care plans; and Control - standardized usual care. Results: The intervention strategy resulted in mean cost savings per patient of -512.77 (95 percent confidence interval [CI], -1086.46-91.98) and an increase in mean quality-adjusted life-years (QALYs) per patient of 0.0051 (95 percent CI, -0.0101-0.0200), when compared with the control strategy. The probability of the intervention being cost-effective was 94 percent if decision makers are willing to pay -45,000 per additional QALY. Conclusions: Decision makers in both settings must determine whether the level of evidence presented is sufficient to justify the adoption of the SPHERE intervention in clinical practice.en
dc.publisherCambridge University Pressen
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 Ireland
dc.subjectCoronary heart diseaseen
dc.subjectSecondary preventionen
dc.subjectGeneral practiceen
dc.subjectCost-effectiveness analysisen
dc.subjectIrish Centre for Social Gerontologyen
dc.titleThe cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart diseaseen

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