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Expert patients 'are not more cost effective'

By Nigel Praities

Researchers have raised serious doubts about the aims of the Government's expert patient programme, after their study showed it did not improve quality of life or reduce costs in arthritis patients.

The authors of the study say there may be a need for ‘rigorous evaluation' of the cost-effectiveness of the whole programme, as they could not demonstrate any significant benefits after a year.

The study – published online by the British Medical Journal – randomised 812 patients with osteoarthritis to either a self-management programme or usual care from GPs and measured the effects after 12 months.

They found no significant differences in quality of life as measured by questionnaires at 12 months, with an SF-36 physical health summary score of 25.6 in the self-care group and a 25.1 score in the control group.

The difference in QALY scores for both groups were similar, with additional health and social care costs in the self-care group of around £101.

The results are at odds with a Department of Health evaluation of the expert patient programme published earlier this year that called for the programme to be expanded.

The DH evaluation found a six-week online programme resulted in significant reductions in GP visits and emergency visits to hospital, but the authors of this latest independent study are less positive.

Dr Anita Patel, senior lecturer at King's College London, said: ‘Cost effectiveness of an arthritis self-management programme is not suggested on the basis of current NIH or NICE cost perspectives and QALY thresholds.'

‘These results suggest that the cost-effectiveness of the Department of Health expert patients programme cannot be assumed across all clinical conditions and that further rigorous evaluations for other conditions may be needed,' she said.

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