Additional file 1: of Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis

Appendix 1. PubMed search strategy. (DOCX 15 kb

Additional file 2: of Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis

Table S1. Included study characteristics. (DOCX 48 kb

Cost-Effectiveness Analysis of Acupuncture, Counselling and Usual Care in Treating Patients with Depression: The Results of the ACUDep Trial

<div><p>Background</p><p>New evidence on the clinical effectiveness of acupuncture plus usual care (acupuncture) and counselling plus usual care (counselling) for patients with depression suggests the need to investigate the health-related quality of life and costs of these treatments to understand whether they should be considered a good use of limited health resources.</p><p>Methods and Findings</p><p>The cost-effectiveness analyses are based on the Acupuncture, Counselling or Usual care for Depression (ACUDep) trial results. Statistical analyses demonstrate a difference in mean quality adjusted life years (QALYs) and suggest differences in mean costs which are mainly due to the price of the interventions. Probabilistic sensitivity analysis is used to express decision uncertainty. Acupuncture and counselling are found to have higher mean QALYs and costs than usual care. In the base case analysis acupuncture has an incremental cost-effectiveness ratio (ICER) of £4,560 per additional QALY and is cost-effective with a probability of 0.62 at a cost-effectiveness threshold of £20,000 per QALY. Counselling compared with acupuncture is more effective and more costly with an ICER of £71,757 and a probability of being cost-effective of 0.36. A scenario analysis of counselling versus usual care, excluding acupuncture as a comparator, results in an ICER of £7,935 and a probability of 0.91.</p><p>Conclusions</p><p>Acupuncture is cost-effective compared with counselling or usual care alone, although the ranking of counselling and acupuncture depends on the relative cost of delivering these interventions. For patients in whom acupuncture is unavailable or perhaps inappropriate, counselling has an ICER less than most cost-effectiveness thresholds. However, further research is needed to determine the most cost-effective treatment pathways for depressed patients when the full range of available interventions is considered.</p></div

CONSORT flow diagram.

<p>CONSORT flow diagram.</p

Complete case and imputed mean number of service use contacts over 12 months.

<p>Complete case and imputed mean number of service use contacts over 12 months.</p

Demographics and variables of interest at bastline.

<p>Percent given out of non-missing data, percent missing given out of applicable group total.</p><p>A BDI-II score of 20 or above was required to be eligible for the trial.</p

Effect of trial arm on PHQ-9 depression.

a<p>ANCOVA, effect of trial arm on imputed PHQ-9 at 3 months (adjusting for baseline PHQ-9).</p>b<p>Mixed, effect of trial arm on PHQ-9 over 12 months, (mixed effects model, including time, trial arm x time, baseline PHQ-9, baseline expectation of counselling and baseline expectation of allocated treatment. For the comparison between acupuncture and counselling, treatment time by 3 months and practitioner's empathy were additionally included.)</p>c<p>AUC, effect of trial arm on average PHQ-9 depression over 12 months (adjusting for Baseline PHQ-9).</p><p>SE, standard error.</p

Effect of trial arm on BDI-II depression.

a<p>ANCOVA, effect of trial arm on imputed BDI-II at 12 months (adjusting for baseline BDI-II, baseline expectation of counselling and baseline expectation of allocated treatment. For the comparison between acupuncture and counselling, treatment time by 3 months and practitioner's empathy were additionally included.)</p

Health-related quality-of-life scores over time and by treatment.

<p>Health-related quality-of-life scores over time and by treatment.</p

Out-of-pocket costs and days of work for complete cases.

<p>Out-of-pocket costs and days of work for complete cases.</p