Cost-effectiveness of counselling, graded-exercise and usual care for chronic fatigue: evidence from a randomised trial in primary care

摘要: Background: Fatigue is common and has been shown to result in high economic costs society. The aim of this study compare the cost-effectiveness two active therapies, graded-exercise (GET) counselling (COUN) with usual care plus a self-help booklet (BUC) for people presenting chronic fatigue. Methods: A randomised controlled trial was conducted participants consulting fatigue over three months’ duration recruited from 31 general practices South East England allocated one arms. Outcomes use services were assessed at 6-month follow-up. main outcome measure used evaluation clinically significant improvements fatigue, measured using Chalder scale. Cost-effectiveness net-benefit approach acceptability curves. Results: Full data six months available 163 participants; GET=51, COUN=58 BUC=54. Those receiving therapies (GET COUN) had more contacts professionals therefore higher costs, these differences being statistically significant. COUN expensive less effective than other therapies. incremental ratio GET compared BUC equal £987 per unit improvement. However, there much uncertainty around result. Conclusion: This does not provide clear recommendation about which therapeutic option adopt, based on efficiency, patients It suggests that cost-effective, but it unclear whether represents value money BUC. Clinical Trial Registration number ISRCTN register: 72136156