Cost-effectiveness of C-reactive protein testing to reduce antibiotic use in COPD
Author Information
Author(s): Sewell Bernadette, Francis Nick, Harris Shaun, Gillespie David, Bates Janine, White Patrick, Alam Mohammed Fasihul, Hood Kerenza, Butler Christopher C, Fitzsimmons Deborah
Primary Institution: Swansea University
Hypothesis
Is C-reactive protein point-of-care testing cost-effective for reducing antibiotic consumption in patients with acute exacerbations of chronic obstructive pulmonary disease?
Conclusion
C-reactive protein point-of-care testing is a cost-effective intervention for safely reducing antibiotic consumption in patients with acute exacerbations of chronic obstructive pulmonary disease.
Supporting Evidence
- CRP-POCT led to a 20% absolute reduction in antibiotic consumption.
- The mean incremental cost-effectiveness ratio was £120 per 1% reduction in antibiotic consumption.
- There is a 73% probability of CRP-POCT being cost-effective at a willingness-to-pay threshold of £20,000 per QALY gained.
- Both groups had similar clinical outcomes, indicating non-inferiority in health status.
Takeaway
Doctors can use a simple test to see if patients with breathing problems need antibiotics, which helps avoid giving them when they don't need it.
Methodology
A multicentre, parallel-arm, open, individually randomised controlled trial was conducted to evaluate the cost-effectiveness of C-reactive protein point-of-care testing in primary care.
Potential Biases
The study may have biases related to the perspective taken and the short follow-up period.
Limitations
The study was limited by its UK National Health Service perspective, which does not account for wider societal costs, and the short-term follow-up that may not capture long-term outcomes.
Participant Demographics
Participants were adults presenting with acute exacerbations of chronic obstructive pulmonary disease in primary care.
Statistical Information
P-Value
0.031
Confidence Interval
95% CI −£116.49 to £130.11
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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