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Estimating the cost consequence of the early use of botulinum toxin in post-stroke spasticity: Secondary analysis of a randomised controlled trial.

Lindsay, C., Humphreys, I., Phillips, C. and Pandyan, A., 2022. Estimating the cost consequence of the early use of botulinum toxin in post-stroke spasticity: Secondary analysis of a randomised controlled trial. Clinical Rehabilitation. (In Press)

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DOI: 10.1177/02692155221133522

Abstract

OBJECTIVE: To estimate the cost-consequence of treating spasticity early with botulinum toxin in the acute stroke unit. DESIGN: Secondary cost-consequence analysis, using data from a double-blind randomised-controlled trial. SETTING: Single-centre specialised stroke unit. SUBJECTS AND INTERVENTIONS: Patients with Action Research Arm Test grasp-score of <2 and who developed spasticity within six weeks of a first stroke were randomised to receive injections of: 0.9% sodium-chloride solution (placebo) or onabotulinumtoxin-A (treatment). MAIN MEASURES: Resource use costs were calculated for the study. Mean contracture costs for each group were calculated. The Barthel Index and Action Research Arm Test were used to generate a cost per unit of improvement. RESULTS: There were no significant differences associated with early treatment use. The mean contracture cost for the treatment group was £817 and for the control group was £2298 (mean difference = -£1481.1(95% CI -£2893.5, -£68.7) (p = 0.04). The cost per unit of improvement for the Barthel Index was -£1240 indicating that the intervention costs less and is more effective. The cost per unit of improvement for the Action Research Arm Test was -£450 indicating that the intervention costs less and is more effective. CONCLUSIONS: Treating spasticity early in stroke patients at risk of contractures with botulinum toxin leads to a significant reduction in contracture costs. The cost per improvement of Barthel and Action Research Arm Test indicates that the intervention costs less and is more effective. TRIAL REGISTRATION DATA: EudraCT(2010-021257-39) and ClinicalTrials.gov-Identifier:NCT01882556.

Item Type:Article
ISSN:0269-2155
Uncontrolled Keywords:Stroke; botulinum toxin; economic evaluation; spasticity
Group:Faculty of Health & Social Sciences
ID Code:37800
Deposited By: Symplectic RT2
Deposited On:11 Nov 2022 17:04
Last Modified:11 Nov 2022 17:04

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