Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.

<h4>Background</h4>Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers a...

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Autores principales:	Natasja H J van Veen, Paul McNamee, Jan Hendrik Richardus, W Cairns S Smith
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a09e81b0e0544a8fb98bd93709c9c12a
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spelling	oai:doaj.org-article:a09e81b0e0544a8fb98bd93709c9c12a2021-12-02T20:12:16ZCost-effectiveness of interventions to prevent disability in leprosy: a systematic review.1932-620310.1371/journal.pone.0004548https://doaj.org/article/a09e81b0e0544a8fb98bd93709c9c12a2009-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19229328/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and opportunities to achieving universal coverage and access with limited resources. The purpose of this study was to systematically review the quality of existing cost-effectiveness evidence and discuss implications for future research and strategies to prevent disability in leprosy and other disabling conditions.<h4>Methodology/principal findings</h4>We searched electronic databases (NHS EED, MEDLINE, EMBASE, and LILACS) and databases of ongoing trials (www.controlled-trials.com/mrct/, www.who.int/trialsearch). We checked reference lists and contacted experts for further relevant studies. We included studies that reported both cost and effectiveness outcomes of two or more alternative interventions to prevent disability in leprosy. We assessed the quality of the identified studies using a standard checklist for critical appraisal of economic evaluations of health care programmes. We found 66 citations to potentially relevant studies and three met our criteria. Two were randomised controlled trials (footwear, management of neuritis) and one was a generic model-based study (cost per DALY). Generally, the studies were small in size, reported inadequately all relevant costs, uncertainties in estimates, and issues of concern and were based on limited data sources. No cost-effectiveness data on self-care, which is a key strategy in POD, was found.<h4>Conclusion/significance</h4>Evidence for cost-effectiveness of POD interventions for leprosy is scarce. High quality research is needed to identify POD interventions that offer value for money where resources are very scarce, and to develop strategies aimed at available, affordable and sustainable quality POD services for leprosy. The findings are relevant for other chronically disabling conditions, such as lymphatic filariasis, Buruli ulcer and diabetes in developing countries.Natasja H J van VeenPaul McNameeJan Hendrik RichardusW Cairns S SmithPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 2, p e4548 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Natasja H J van Veen Paul McNamee Jan Hendrik Richardus W Cairns S Smith Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.
description	<h4>Background</h4>Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and opportunities to achieving universal coverage and access with limited resources. The purpose of this study was to systematically review the quality of existing cost-effectiveness evidence and discuss implications for future research and strategies to prevent disability in leprosy and other disabling conditions.<h4>Methodology/principal findings</h4>We searched electronic databases (NHS EED, MEDLINE, EMBASE, and LILACS) and databases of ongoing trials (www.controlled-trials.com/mrct/, www.who.int/trialsearch). We checked reference lists and contacted experts for further relevant studies. We included studies that reported both cost and effectiveness outcomes of two or more alternative interventions to prevent disability in leprosy. We assessed the quality of the identified studies using a standard checklist for critical appraisal of economic evaluations of health care programmes. We found 66 citations to potentially relevant studies and three met our criteria. Two were randomised controlled trials (footwear, management of neuritis) and one was a generic model-based study (cost per DALY). Generally, the studies were small in size, reported inadequately all relevant costs, uncertainties in estimates, and issues of concern and were based on limited data sources. No cost-effectiveness data on self-care, which is a key strategy in POD, was found.<h4>Conclusion/significance</h4>Evidence for cost-effectiveness of POD interventions for leprosy is scarce. High quality research is needed to identify POD interventions that offer value for money where resources are very scarce, and to develop strategies aimed at available, affordable and sustainable quality POD services for leprosy. The findings are relevant for other chronically disabling conditions, such as lymphatic filariasis, Buruli ulcer and diabetes in developing countries.
format	article
author	Natasja H J van Veen Paul McNamee Jan Hendrik Richardus W Cairns S Smith
author_facet	Natasja H J van Veen Paul McNamee Jan Hendrik Richardus W Cairns S Smith
author_sort	Natasja H J van Veen
title	Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.
title_short	Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.
title_full	Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.
title_fullStr	Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.
title_full_unstemmed	Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.
title_sort	cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/a09e81b0e0544a8fb98bd93709c9c12a
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Cost-effectiveness of interventions to prevent disability in leprosy: a systematic review.

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