Volume 158, Issue 5 pp. 1013-1021

Costs and cost-effectiveness of the nursing programme ‘Coping with itch’ for patients with chronic pruritic skin disease

H. Van Os-Medendorp

H. Van Os-Medendorp

Department of Dermatology

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C.L.H. Guikers

C.L.H. Guikers

Department of Dermatology

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P.C.M. Eland-de Kok

P.C.M. Eland-de Kok

Department of Dermatology

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W.J.G. Ros

W.J.G. Ros

Julius Centre, Nursing Sciences, University Medical Centre Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA Utrecht, the Netherlands

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C.A.F.M. Bruijnzeel-Koomen

C.A.F.M. Bruijnzeel-Koomen

Department of Dermatology

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E. Buskens

E. Buskens

Department of Epidemiology, University Medical Centre Groningen, Groningen, the Netherlands

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First published: 20 March 2008
Citations: 10
Harmieke van Os-Medendorp.
E-mail: [email protected]

Conflicts of interest
None declared.

Summary

Background  Itch, a major symptom of many skin diseases, has a great impact on quality of life. The nursing programme ‘Coping with itch’ aims at reducing itch and at helping patients to cope with itch.

Objectives  To explore costs and cost-effectiveness of the programme.

Methods  A randomized controlled study was carried out with 56 patients. Data were gathered on medical consumption, days off work and the frequency of itching and scratching. Differences between both groups, the cost-effectiveness ratio and the percentage of patients falling into the four quadrants of the cost-effectiveness analysis plane were determined.

Results  The intervention group experienced a gain of 6 days with little itching [95% confidence interval (CI) –16–28] at 3 months and a gain of 35 days (95% CI –33–96) at 9 months. They paid more visits to the dermatology nurse than the control group. The point estimate of the incremental cost-effectiveness ratio was €129·91 and €16·60 per day with little itching at 3 months and at 9 months, respectively. At 3 months, 70% of the patients experienced favourable results and 14% of them had lower costs. At 9 months, 87% had favourable results and 31% of them had lower costs.

Conclusions  Most of the expenses associated with the ‘Coping with itch’ programme were incurred during the first 3 months, but the benefits in terms of days with little itch appeared to persist and increase beyond 3 months, thus leading to a more favourable incremental cost-effectiveness ratio.

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