Optimising breathlessness services for older people with advanced diseases: a multicentre economic study (OPTBreathe)
12th June 2023
In advanced disease, breathlessness becomes severe, increasing health services use. Breathlessness Services demonstrate effectiveness in trials and meta-analyses but lack health economic assessment. As part of a research study called OPTBreathe, researchers based at the Cicely Saunders Institute set out to investigate the cost-effectiveness of Breathlessness Services for older people with chronic breathlessness and their carers.
Researchers carried out face-to-face interviews with 190 older patients with chronic breathlessness and 68 carers across nine UK centres. This was followed by a cost-effectiveness analysis to determine preferences (or not) for the services. Economic modelling estimated the costs and quality-adjusted life years (QALYs) over five years.
The research found that offering Breathlessness Services in person from general practitioner (GP) surgeries was not preferred. Hospital outpatient clinics or via home visits were preferred. Inperson services with comprehensive treatment review and holistic support were preferred to those without.
A cost-effectiveness analysis found the most and the least preferred models of Breathlessness Services were cost-effective compared with usual care. The most preferred service had £5719 lower costs per patient. Uptake was higher when attributes were tailored to individual preferences (86% vs 40%).
The researchers conclude that Breathlessness Services are cost-effective compared with usual care for health and social care, giving cost savings and better quality of life. Uptake of Breathlessness Services is higher when service are individually tailored.
Yi D, Reilly CC, Wei G, Higginson IJ; OPTBreathe collaborators. Optimising breathlessness triggered services for older people with advanced diseases: a multicentre economic study (OPTBreathe). Thorax. 2023 May;78(5):489-495. doi: 10.1136/thoraxjnl-2021-218251. Epub 2022 Aug 15. PMID: 35970540; PMCID: PMC10176396.