Is self-care a cost-effective use of resources? Evidence from a randomized trial in inflammatory bowel disease

Objectives: To determine if a whole-system approach to self-management in inflammatory bowel disease (IBD), using a guidebook developed with patients and physicians trained in patient-centred care, leads to cost-effective use of health system resources.Methods: Cost-effectiveness analysis over a one-year time horizon comparing the whole systems self-management approach to treatment with usual treatment. Nineteen hospitals in the northwest England were randomized to the intervention or to be controls; 651 patients (285 at intervention sites and 366 at control sites) with established IBD were included. The economic evaluation related differential health service costs, from a UK NHS perspective, to differences in quality-adjusted life years (QALYs) based on patients' responses to the EQ-5D.Results: The intervention was associated with a mean reduction in costs of £148 per patient and a small mean reduction in QALYs of 0.00022 per patient compared with the control group. This resulted in an incremental cost p...