TY - JOUR AB - Introduction: Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. The chronic progressive disease is accompanied by a high loss of health-related quality of life (HRQoL). The available drugs usually only have symptomatic effects; therefore, non-pharmacological therapies are essential too. Areas covered: This systematic review examines non-pharmacological interventions consisting of pulmonary rehabilitation, physical activity, and training versus usual care or no intervention in COPD using at least one of the following HRQoL measuring instruments: St. George's Respiratory Questionnaire, Clinical COPD Questionnaire, COPD Assessment Test, and EuroQol-5D. Of 1532 identified records from CENTRAL, MEDLINE, and EMBASE, 15 randomized controlled trials met the inclusion criteria. Pulmonary rehabilitation programs were investigated in nine studies, education and counseling-based training programs in three studies, and breathing exercises in three studies. Ten studies were found that investigated non-pharmacological treatment programs that led to a significant and clinically relevant improvement in HRQoL compared with usual care or no treatment. Expert opinion: Non-pharmacological interventions consisting of pulmonary rehabilitation, education and counseling-based training programs, and breathing exercises can improve the HRQoL of COPD patients. AU - Hindelang, M. AU - Kirsch, F. AU - Leidl, R. C1 - 58475 C2 - 48227 CY - 2-4 Park Square, Milton Park, Abingdon Or14 4rn, Oxon, England SP - 79-91 TI - Effectiveness of non-pharmacological COPD management on health-related quality of life-a systematic review. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 20 IS - 1 PB - Taylor & Francis Ltd PY - 2020 SN - 1473-7167 ER - TY - JOUR AB - Objectives: Patients with chronic obstructive pulmonary disease (COPD) show impairments in health-related quality of life (HRQL). We aimed to find a disease-specific questionnaire for routine application in large cohorts and to assess its additional explanatory power to generic HRQL tool (EQ-5D-5L). Methods: 1,350 participants of the disease management program COPD received the EQ-5D-5L combined with one of the three disease-specific tools: COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ) or St. George’s Respiratory Disease Questionnaire (SGRQ) (450 participants each). We compared metric properties and evaluated the Germany-specific experience-based values (EBVS) and utilities in comparison to the Visual Analogue Scale (VAS). We calculated the additional explanatory power of the identified disease-specific tool on VAS through regression analysis. Results: 344 patients returned the questionnaire. CAT, CCQ, and SGRQ group did not differ regarding baseline characteristics. The questionnaire specific response rates were 33.7% for CAT, 30.5% for CCQ, and 34.6% SGRQ, thereof 94.0%, 94.3%, and 65.6% valid answers, respectively. EBVS was better suited to reflect VAS than utilities. CAT increased the explanatory power by 10%. Conclusion: CAT outperformed CCQ and SGRQ, and it increased the explanatory power of VAS. EBV combined with CAT seems superior to only generic or disease-specific approaches. AU - Szentes, B.L. AU - Schwarzkopf, L. AU - Kirsch, F. AU - Schramm, A.* AU - Leidl, R. C1 - 56887 C2 - 47356 SP - 523-529 TI - Measuring quality of life in COPD patients: Comparing disease-specific supplements to the EQ-5D-5L. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 20 IS - 5 PY - 2019 SN - 1473-7167 ER - TY - JOUR AB - Smoking cessation is the only strategy that has shown a lasting reduction in the decline of lung function in patients with chronic obstructive pulmonary disease. This study aims to evaluate the cost-effectiveness of smoking cessation interventions in patients with chronic obstructive pulmonary disease, to assess the quality of the Markov models and to estimate the consequences of model structure and input data on cost-effectiveness. A systematic literature search was conducted in PubMed, Embase, BusinessSourceComplete and Econlit on June 11, 2014. Data were extracted, and costs were inflated. Model quality was evaluated by a quality appraisal, and results were interpreted. Ten studies met the inclusion criteria. The results varied widely from cost savings to additional costs of €17,004 per quality adjusted life year. The models scored best in the category structure, followed by data and consistency. The quality of the models seems to rise over time, and regarding the results there is no economic reason to refuse the reimbursement of any smoking cessation intervention. AU - Kirsch, F. C1 - 43187 C2 - 36082 CY - London SP - 301-316 TI - A systematic review of quality and cost-effectiveness derived from Markov models evaluating smoking cessation interventions in patients with chronic obstructive pulmonary disease. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 15 IS - 2 PB - Expert Reviews PY - 2015 SN - 1473-7167 ER - TY - JOUR AB - Diabetes is the most expensive chronic disease; therefore, disease management programs (DMPs) were introduced. The aim of this review is to determine whether Markov models are adequate to evaluate the cost–effectiveness of complex interventions such as DMPs. Additionally, the quality of the models was evaluated using Philips and Caro quality appraisals. The five reviewed models incorporated the DMP into the model differently: two models integrated effectiveness rates derived from one clinical trial/meta-analysis and three models combined interventions from different sources into a DMP. The results range from cost savings and a QALY gain to costs of US$85,087 per QALY. The Spearman’s rank coefficient assesses no correlation between the quality appraisals. With restrictions to the data selection process, Markov models are adequate to determine the cost–effectiveness of DMPs; however, to allow prioritization of medical services, more flexibility in the models is necessary to enable the evaluation of single additional interventions. AU - Kirsch, F. C1 - 47583 C2 - 39372 SP - 961-984 TI - A systematic review of Markov models evaluating multicomponent disease management programs in diabetes. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 15 IS - 6 PY - 2015 SN - 1473-7167 ER - TY - JOUR AB - © 2015 Taylor & Francis The aim of this study was to evaluate the inter-rater reliability of the Phillips-checklist, a proposed framework for the quality assessment of modeling studies. Six raters evaluated nine modeling studies from three different medical specialties. Intra-class correlation (ICC) and corresponding variance components were estimated from these studies. Raters were asked to comment on their experience with the framework. While overall the mean inter-rater reliability showed no significant rater-effect (ICC = 0.69, p = 0.064), there was – presumably as a result of a lower study variability – a significant rater effect for clopidogrel only (p < 0.001). The framework allowed a more structured methodological assessment but several items remained unclear. Regarding the quality assessment of modeling studies with the proposed framework, the rater variability is similar or even higher than variability because of studies or residual effects. Several scoring items can and should be improved to ease interpretation. AU - Müller, D.* AU - Gerber-Grote, A.* AU - Stollenwerk, B. AU - Stock, S.* AU - Auweiler, P.* AU - Frey, S.* AU - Adarkwah, C.C.* AU - de Kinderen, R.* AU - Hellmich, M.* C1 - 47598 C2 - 39408 CY - Abingdon SP - 619-627 TI - Reporting health care decision models: A prospective reliability study of a multidimensional evaluation framework. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 16 IS - 5 PB - Taylor & Francis Ltd PY - 2015 SN - 1473-7167 ER - TY - JOUR AB - Atrial fibrillation (AF) is the most common heart rhythm arrhythmia, which has considerable economic consequences. This study aims to identify the current cost-of-illness estimates of AF; a focus was put on describing the studies' methodology. A literature review was conducted. Twenty-eight cost-of-illness studies were identified. Cost-of-illness estimates exist for health insurance members, hospital and primary care populations. In addition, the cost of stroke in AF patients and the costs of post-operative AF were calculated. The methods used were heterogeneous, mostly studies calculated excess costs. The identified annual excess costs varied, even among studies from the USA (∼US$1900 to ∼US$19,000). While pointing toward considerable costs, the cost-of-illness studies' relevance could be improved by focusing on subpopulations and treatment mixes. As possible starting points for subsequent economic studies, the methodology of cost-of-illness studies should be taken into account using methods, allowing stakeholders to find suitable studies and validate estimates. AU - Becker, C. C1 - 31802 C2 - 34815 CY - London SP - 661-684 TI - Cost-of-illness studies of atrial fibrillation: Methodological considerations. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 14 IS - 5 PB - Expert Reviews PY - 2014 SN - 1473-7167 ER - TY - JOUR AB - As in most countries, overweight and obesity among children and adolescents have dramatically increased in Germany over the last two decades. This serious public-health challenge has stimulated many efforts to curb the pediatric obesity epidemic. In this article, the authors briefly describe these efforts and examine the role of health economics in informing German health policies and evaluating the outcomes of interventions aimed at reducing pediatric obesity. The findings indicate that the tools of health-economic analysis have rarely been used to guide the development of strategies to prevent pediatric obesity and to support decision-making on the use of the scarce resources available for preventive actions. The authors give some reasons why health economics has not been an important policy tool so far and make some recommendations for how this could be changed. Reasons impeding health economics playing a more important role in this area are the existence of many unsolved issues in the methods of health economic evaluation and large gaps in the knowledge base on the effectiveness of interventions. Nevertheless, these methods should be considered to be indispensible tools of health policy development. However, taking into account the broad range of political and societal concerns related to pediatric obesity, decision-making in this area will ultimately rest on a process of deliberate thinking integrating different perspectives among, which health economics will be one. AU - John, J. AU - Teuner, C.M. C1 - 22825 C2 - 30945 SP - 733-743 TI - Combating pediatric obesity in Germany: The role of economic findings in informing policy. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 12 IS - 6 PB - Expert Reviews PY - 2012 SN - 1473-7167 ER - TY - JOUR AB - Aims: Diabetes mellitus has important economic impacts worldwide. Interventions to prevent diabetes-related complications are often analyzed using model-based cost-effectiveness analyses. As model results are usually influenced by structural assumptions and by the data used, decision-makers should be able to assess the quality of diabetes models. The aim of this study was to assess the quality of selected diabetes models and to determine if modeling recommendations by the American Diabetes Association are considered. Methods: The quality of three selected diabetes models (Archimedes Model, CDC Model and Center for Outcomes Research [CORE] Diabetes Model) was assessed using systematic methods. Results: This systematic approach to assess model quality proved to be feasible and highlighted two areas for improvement: the rationale for model structure and methods to identify parameter values, which should be presented more transparently. Conclusions: Overall, the need for a quality assessment of diabetes models is emphasized. AU - Becker, C. AU - Langer, A. AU - Leidl, R. C1 - 6034 C2 - 29251 SP - 751-761 TI - The quality of three decision-analytic diabetes models: A systematic health economic assessment. JO - Expert Rev. Pharmacoecon. Outcomes Res. VL - 11 IS - 6 PB - Expert Reviews Ltd. PY - 2011 SN - 1473-7167 ER -