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Economic evaluation of the use of point-of-care devices in patients with long term oral anticoagulation / Sophie Gerkens in Journal of thrombosis and thrombolysis, 34(2012)03 ([10/01/2012])
[article] Economic evaluation of the use of point-of-care devices in patients with long term oral anticoagulation [printed text] / Sophie Gerkens, Author ; Jeannine Gailly, Author ; Caroline Obyn, Author ; Stephan Devriese, Author ; Irina Cleemput , Author . - 2012 . - p. 300-309.
Languages : English (eng)
in Journal of thrombosis and thrombolysis > 34(2012)03 [10/01/2012] . - p. 300-309
W 1 Serials. Periodicals
administration and dosage ; Administration, Oral ; Anticoagulants ; Costs and Cost Analysis ; Journal Article ; Monitoring, Physiologic ; Peer Review ; Point-of-Care Systems ; Time Factors
Abstract: To examine the cost and cost-effectiveness of the use of point-of-care (POC) devices by the general practitioner (GP), in anticoagulation clinic or by the patient in self-testing (PST) and self-management (PSM), compared with standard laboratory testing to realize international normalized ratio tests for patients on long term anticoagulation therapy. An economic evaluation was performed from the Belgian health care payer's perspective using a Markov model. Outcomes data were derived from a meta-analysis and cost data were derived from claims databases. Several scenarios were tested based on number of tests and GP's contacts and probabilistic sensitivity analysis was used to handle uncertainty. Evidence on the impact of POC on mortality was only found for PSM. Therefore, a cost-effectiveness analysis was performed for PSM and for other strategies, only a cost comparison was done. With an unchanged number of tests, POC is cost-saving compared to laboratory testing (probability > 70%). In scenarios where POC induces more tests, results were different: with 52 tests/year, only PSM kept a probability of remaining cost-saving superior to 50%. Except in the case of 100% of GP consultations maintained and 52 tests/year performed, PSM resulted in significantly more "life years gained" (LYG) than usual care and was on average cost-saving. The organisation of long term oral anticoagulation monitoring should be directed towards PSM and, to a lesser extent, PST for selected and trained patients. Link for e-copy: http://doi.org/10.1007/s11239-012-0715-9 Format of e-copy: PDF [Requires Subscription] Record link: [article]Quality improvement of the management of oral anticoagulation by Belgian general practitioners / Neree Claes / Leuven [Belgium] : Katholieke Universiteit Leuven (KUL) (2005)
Quality improvement of the management of oral anticoagulation by Belgian general practitioners [printed text] / Neree Claes, Author . - Leuven (Belgium) : Katholieke Universiteit Leuven (KUL) : Leuven (Belgium) : ACCO, 2005 . - 160 p. : ill. ; 24 cm. - (Faculteit der Geneeskunde = Faculty of Medicine) .
ISBN : 978-90-75828-11-5 : 0,00
Thesis submitted in fulfiment of the requirements for the degree of 'Doctor in de Biomedische Wetenschappen'
Languages : English (eng)
Administration, Oral ; Aged ; Anticoagulants ; Belgium ; Clinical Trials ; Cost-effectiveness analysis ; Costs and Cost Analysis ; Drug Monitoring ; drug therapy ; Physician's Practice Patterns ; Physicians, Family ; Quality of Health Care ; Therapy
QV 193 Anticoagulants
Contents note: Table of Contents -- Chapter 1 Introduction 7 -- Chapter 2 Quality assessment of oral anticoagulation in Belgium, as practiced by a group of GPs 41 -- Chapter 3 The Belgian Improvement Study on Oral Anticoagulation Therapy (BISOAT-study): a randomized clinical trial 57 -- Chapter 4 Appreciation of interventions to improve oral anticoagulant monitoring by GPs (the BISOAT-study) 79 -- Chapter 5 Cost-effectiveness of quality improving interventions in oral anticoagulation management within the general practice 93 -- Chapter 6 General discussion 115 -- Summary 141 -- Samenvatting 145 -- Dankwoord 149 -- Curriculum Vitae 159 Link for e-copy: https://lirias.kuleuven.be/bitstream/1979/214/2/boek260805.pdf Format of e-copy: PDF [Open Access] (1,53 MB) Record link:
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Barcode Call number Media type Location Section Status 10273-02047 QV 193 / CLA Thesis KCE Library (10.124) Available