Enhanced recovery following hip and knee arthroplasty: a systematic review of cost-effectiveness evidence

被引:14
|
作者
Pritchard, Mark G. [1 ,2 ]
Murphy, Jacqueline [1 ,3 ]
Cheng, Lok [1 ,4 ]
Janarthanan, Roshni [1 ,2 ]
Judge, Andrew [5 ,6 ]
Leal, Jose [1 ]
机构
[1] Univ Oxford, Nuffield Dept Populat Hlth, Oxford, England
[2] Oxford Univ Hosp NHS Fdn Trust, John Radcliffe Hosp, Oxford, England
[3] Queen Mary Univ London, Wolfson Inst Prevent Med Barts & London, London, England
[4] Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hosp, Aylesbury, Bucks, England
[5] Univ Bristol, Bristol Med Sch, Translat Hlth Sci, Musculoskeletal Res Unit, Bristol, Avon, England
[6] Univ Oxford, NDORMS, Oxford, England
来源
BMJ OPEN | 2020年 / 10卷 / 01期
关键词
systematic review; hip replacement; knee replacement; osteoarthritis; economic evaluation; cost-effectiveness; ACCELERATED PERIOPERATIVE CARE; TOTAL JOINT ARTHROPLASTY; SURGICAL SITE INFECTION; VENOUS THROMBOEMBOLISM; ECONOMIC EVALUATIONS; REPLACEMENT SURGERY; LIFETIME RISK; UTILIZATION RATES; HEALTH; PROGRAM;
D O I
10.1136/bmjopen-2019-032204
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives To assess cost-effectiveness of enhanced recovery pathways following total hip and knee arthroplasties. Secondary objectives were to report on quality of studies and identify research gaps for future work. Design Systematic review of cost-utility analyses. Data sources Ovid MEDLINE, Embase, the National Health Service Economic Evaluations Database and EconLit, January 2000 to August 2019. Eligibility criteria English-language peer-reviewed cost-utility analyses of enhanced recovery pathways, or components of one, compared with usual care, in patients having total hip or knee arthroplasties for osteoarthritis. Data extraction and synthesis Data extracted by three reviewers with disagreements resolved by a fourth. Study quality assessed using the Consensus on Health Economic Criteria list, the International Society for Pharmacoeconomics and Outcomes Research and Assessment of the Validation Status of Health-Economic decision models tools; for trial-based studies the Cochrane Collaboration's tool to assess risk of bias. No quantitative synthesis was undertaken. Results We identified 17 studies: five trial-based and 12 model-based studies. Two analyses evaluated entire enhanced recovery pathways and reported them to be cost-effective compared with usual care. Ten pathway components were more effective and cost-saving compared with usual care, three were cost-effective, and two were not cost-effective. We had concerns around risk of bias for all included studies, particularly regarding the short time horizon of the trials and lack of reporting of model validation. Conclusions Consistent results supported enhanced recovery pathways as a whole, prophylactic systemic antibiotics, antibiotic-impregnated cement and conventional ventilation for infection prevention. No other interventions were subject of more than one study. We found ample scope for future cost-effectiveness studies, particularly analyses of entire recovery pathways and comparison of incremental changes within pathways. A key limitation is that standard practices have changed over the period covered by the included studies. PROSPERO registration number CRD42017059473.
引用
收藏
页数:12
相关论文
共 50 条
  • [1] Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol
    Murphy, Jacqueline
    Pritchard, Mark G.
    Cheng, Lok Yin
    Janarthanan, Roshni
    Leal, Jose
    BMJ OPEN, 2018, 8 (03):
  • [2] Modelling the cost-effectiveness of total knee arthroplasty: A systematic review
    Kamaraj, Achi
    To, Kendrick
    Seah, K. T. Matthew
    Khan, Wasim S.
    JOURNAL OF ORTHOPAEDICS, 2020, 22 : 485 - 492
  • [3] Cost-Effectiveness of Arthroplasty Management in Hip and Knee Osteoarthritis: a Quality Review of the Literature
    Codie A. Primeau
    Ishita Joshi
    Bryn O. Zomar
    Lyndsay E. Somerville
    Holly T. Philpott
    David D. McHugh
    Brent A. Lanting
    Edward M. Vasarhelyi
    Jacquelyn D. Marsh
    Current Treatment Options in Rheumatology, 2020, 6 : 160 - 190
  • [4] Cost-Effectiveness of Arthroplasty Management in Hip and Knee Osteoarthritis: a Quality Review of the Literature
    Primeau, Codie A.
    Joshi, Ishita
    Zomar, Bryn O.
    Somerville, Lyndsay E.
    Philpott, Holly T.
    McHugh, David D.
    Lanting, Brent A.
    Vasarhelyi, Edward M.
    Marsh, Jacquelyn D.
    CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY, 2020, 6 (03) : 160 - 190
  • [5] Enhanced Recovery After Primary Total Hip and Knee Arthroplasty A Systematic Review
    Morrell, Aidan T.
    Layon, Daniel R.
    Scott, Michael J.
    Kates, Stephen L.
    Golladay, Gregory J.
    Patel, Nirav K.
    JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2021, 103 (20): : 1938 - 1947
  • [6] Enhanced recovery after surgery for primary hip and knee arthroplasty: a review of the evidence
    Soffin, E. M.
    YaDeau, J. T.
    BRITISH JOURNAL OF ANAESTHESIA, 2016, 117 : 62 - 72
  • [7] Cost-Effectiveness of Nonpharmacologic, Nonsurgical Interventions for Hip and/or Knee Osteoarthritis: Systematic Review
    Pinto, Daniel
    Robertson, M. Clare
    Hansen, Paul
    Abbott, J. Haxby
    VALUE IN HEALTH, 2012, 15 (01) : 1 - 12
  • [8] A SYSTEMATIC LITERATURE REVIEW OF THE COST-EFFECTIVENESS OF ERYTHROPOIETIN IN ORTHOPEDIC SURGERY: THERE IS A NEED FOR DIFFERENTIATION BETWEEN TOTAL HIP AND KNEE ARTHROPLASTY
    Degener, F.
    Postma, M. J.
    VALUE IN HEALTH, 2015, 18 (03) : A160 - A160
  • [9] Cost-Effectiveness of Rivaroxaban After Total Hip or Total Knee Arthroplasty
    Kwong, Louis M.
    AMERICAN JOURNAL OF MANAGED CARE, 2011, 17 (01): : S22 - S26
  • [10] Effectiveness of eHealth Tools for Hip and Knee Arthroplasty: A Systematic Review
    Mohammadi, Somayyeh
    Miller, William C.
    Wu, Julia
    Pawliuk, Colleen
    Robillard, Julie M.
    FRONTIERS IN REHABILITATION SCIENCES, 2021, 2