TY - JOUR
T1 - Does the use of patient decision aids lead to cost savings? a systematic review
AU - Scalia, Peter
AU - Barr, Paul J.
AU - O'Neill, Ciaran
AU - Crealey, Grainne E.
AU - Bagley, Pamela J.
AU - Blunt, Heather B.
AU - Elwyn, Glyn
PY - 2020/11/16
Y1 - 2020/11/16
N2 - Objectives: To update a previous systematic review to determine if patient decision aid (PDA) interventions generate savings in healthcare settings, and if so, from which perspective (ie, patient, organisation providing care, society). Design Systematic review. Data sources MEDLINE, CINAHL, PsycINFO, Web of Science, Cochrane Library, Embase, Campbell Collaboration Library, EconLit, Business Source Complete, Centre for Reviews and Dissemination: NHS Economic Evaluations Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA) from 15 March 2013 to 25 January 2019. The references of studies that met the eligibility criteria and any publications related to conference abstracts or registered clinical trials were reviewed to increase the sensitivity of the search. Eligibility criteria: Full and partial economic evaluations with an experimental, quasi-experimental or randomised controlled design were included. The intervention had to satisfy the pre-determined minimum conditions necessary to be defined as a PDA, and (for full evaluations) provide details on the comparator used. Data extraction and synthesis: All study outcomes and economic data were extracted. The reporting and quality of the economic analyses were independently assessed by two health economists. Results: Of 5066 studies, 22 studies were included, including the 8 studies from the previous review. Twelve studies reported cost-savings (range=US$10 to US$81 156; US dollars in 2020), primarily from the organisational or health system perspective, and 10 studies did not. However, due to the quality of the economic analyses, and the related issues with the interpretative validity of results it would be inappropriate to say that PDAs will generate savings, from any perspective. Conclusions: It is unclear whether PDAs will generate savings. Greater consensus on what constitutes a PDA and the need to compare them against usual care over a sufficient time horizon to allow valid assessment of costs and outcomes is required.
AB - Objectives: To update a previous systematic review to determine if patient decision aid (PDA) interventions generate savings in healthcare settings, and if so, from which perspective (ie, patient, organisation providing care, society). Design Systematic review. Data sources MEDLINE, CINAHL, PsycINFO, Web of Science, Cochrane Library, Embase, Campbell Collaboration Library, EconLit, Business Source Complete, Centre for Reviews and Dissemination: NHS Economic Evaluations Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA) from 15 March 2013 to 25 January 2019. The references of studies that met the eligibility criteria and any publications related to conference abstracts or registered clinical trials were reviewed to increase the sensitivity of the search. Eligibility criteria: Full and partial economic evaluations with an experimental, quasi-experimental or randomised controlled design were included. The intervention had to satisfy the pre-determined minimum conditions necessary to be defined as a PDA, and (for full evaluations) provide details on the comparator used. Data extraction and synthesis: All study outcomes and economic data were extracted. The reporting and quality of the economic analyses were independently assessed by two health economists. Results: Of 5066 studies, 22 studies were included, including the 8 studies from the previous review. Twelve studies reported cost-savings (range=US$10 to US$81 156; US dollars in 2020), primarily from the organisational or health system perspective, and 10 studies did not. However, due to the quality of the economic analyses, and the related issues with the interpretative validity of results it would be inappropriate to say that PDAs will generate savings, from any perspective. Conclusions: It is unclear whether PDAs will generate savings. Greater consensus on what constitutes a PDA and the need to compare them against usual care over a sufficient time horizon to allow valid assessment of costs and outcomes is required.
KW - health economics
KW - health policy
KW - quality in health care
UR - http://www.scopus.com/inward/record.url?scp=85096253168&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2020-036834
DO - 10.1136/bmjopen-2020-036834
M3 - Review article
C2 - 33199416
AN - SCOPUS:85096253168
SN - 2044-6055
VL - 10
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - CD001431
ER -