Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions.
BACKGROUND: Point-of-care C-reactive protein (POCCRP) is a biomarker of inflammation that offers clinicians a rapid POC test to guide antibiotic prescribing decisions for acute cough and lower respiratory tract infections (LRTI). However, evidence that POCCRP is cost-effective is limited, particular...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2013
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| _version_ | 1797099531905531904 |
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| author | Oppong, R Jit, M Smith, R Butler, C Melbye, H Mölstad, S Coast, J |
| author_facet | Oppong, R Jit, M Smith, R Butler, C Melbye, H Mölstad, S Coast, J |
| author_sort | Oppong, R |
| collection | OXFORD |
| description | BACKGROUND: Point-of-care C-reactive protein (POCCRP) is a biomarker of inflammation that offers clinicians a rapid POC test to guide antibiotic prescribing decisions for acute cough and lower respiratory tract infections (LRTI). However, evidence that POCCRP is cost-effective is limited, particularly outside experimental settings. AIM: To assess the cost-effectiveness of POCCRP as a diagnostic tool for acute cough and LRTI from the perspective of the health service. DESIGN AND SETTING: Observational study of the presentation, management, and outcomes of patients with acute cough and LRTI in primary care settings in Norway and Sweden. METHOD: Using hierarchical regression, data were analysed in terms of the effect on antibiotic use, cost, and patient outcomes (symptom severity after 7 and 14 days, time to recovery, and EQ-5D), while controlling for patient characteristics (self-reported symptom severity, comorbidities, and health-related quality of life) at first attendance. RESULTS: POCCRP testing is associated with non-significant positive reductions in antibiotic prescribing (P = 0.078) and increased cost (P = 0.092). Despite the uncertainty, POCCRP testing is also associated with a cost per quality-adjusted life year (QALY) gain of €9391. At a willingness-to-pay threshold of €30,000 per QALY gained, there is a 70% probability of CRP being cost-effective. CONCLUSION: POCCRP testing is likely to provide a cost-effective diagnostic intervention both in terms of reducing antibiotic prescribing and in terms of QALYs gained. |
| first_indexed | 2024-03-07T05:25:06Z |
| format | Journal article |
| id | oxford-uuid:e043ca98-f667-4d14-af94-73e9bd4ac53e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:25:06Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:e043ca98-f667-4d14-af94-73e9bd4ac53e2022-03-27T09:45:56ZCost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e043ca98-f667-4d14-af94-73e9bd4ac53eEnglishSymplectic Elements at Oxford2013Oppong, RJit, MSmith, RButler, CMelbye, HMölstad, SCoast, JBACKGROUND: Point-of-care C-reactive protein (POCCRP) is a biomarker of inflammation that offers clinicians a rapid POC test to guide antibiotic prescribing decisions for acute cough and lower respiratory tract infections (LRTI). However, evidence that POCCRP is cost-effective is limited, particularly outside experimental settings. AIM: To assess the cost-effectiveness of POCCRP as a diagnostic tool for acute cough and LRTI from the perspective of the health service. DESIGN AND SETTING: Observational study of the presentation, management, and outcomes of patients with acute cough and LRTI in primary care settings in Norway and Sweden. METHOD: Using hierarchical regression, data were analysed in terms of the effect on antibiotic use, cost, and patient outcomes (symptom severity after 7 and 14 days, time to recovery, and EQ-5D), while controlling for patient characteristics (self-reported symptom severity, comorbidities, and health-related quality of life) at first attendance. RESULTS: POCCRP testing is associated with non-significant positive reductions in antibiotic prescribing (P = 0.078) and increased cost (P = 0.092). Despite the uncertainty, POCCRP testing is also associated with a cost per quality-adjusted life year (QALY) gain of €9391. At a willingness-to-pay threshold of €30,000 per QALY gained, there is a 70% probability of CRP being cost-effective. CONCLUSION: POCCRP testing is likely to provide a cost-effective diagnostic intervention both in terms of reducing antibiotic prescribing and in terms of QALYs gained. |
| spellingShingle | Oppong, R Jit, M Smith, R Butler, C Melbye, H Mölstad, S Coast, J Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. |
| title | Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. |
| title_full | Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. |
| title_fullStr | Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. |
| title_full_unstemmed | Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. |
| title_short | Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. |
| title_sort | cost effectiveness of point of care c reactive protein testing to inform antibiotic prescribing decisions |
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