The guidelines for use of paracetamol in NSW were adjusted to allow its use in stroke patients with a temperature of >37.5°C (updated from >38°C). Furthermore, the QASC Implementation Project found that participating trial sites were more likely to adhere to the hyperglycemia protocol (the protocol requiring the most amount of multidisciplinary teamwork) than sites that had not participated in the trial. Eligible Outcome participants if Primary outcomes Secondary outcomes Clinical context Main clinical assumptions implemented Treatment Adults with stroke = 90 days after Processes of care: mean The Fever, Sugar, Swallowing (FeSS) Expect functional outcomes as based on Rankin score will delivers better 49,067 hospitalisation: death or temperature; mean finger-prick intervention has since been capture the QALY impact of Barthel and SF-36 indices. patient dependency; functional blood glucose; proportion with successfully implemented into 36 Costing is based on Rankin score. outcomes dependency; mean swallowing screening stroke services in NSW. The NSF Life expectancy based on Harald Hannerz et al. (2001). Proportion of after mental & physical undertaken; discharge clinical audit was also changed, and patients excluded = discharge. components. diagnosis of aspiration the NSW guidelines for paracetamol 69% pneumonia; LOS in hospital. updated. N= 15,211 Difference in risk N if Health Economic Impact on QALY Economic Total Economic Impact Outcome between control and implemented service cost health service costs impact per impact on treatment at 65% per person or if implemented person QALYS if day implemented Primary Functional Based on $ difference for outcomes at 3 treatment and QALY -9,887 -$1,865 -$18m -$26,580 -$263m -$281m months (Rankin between treatment and scale score). control groups. Change in +$0.6m intervention costs Totals -$18m -$263m -$281m Columns may not sum due to rounding. Negative values are savings in the calculations. LOS = length of stay. NSF = National Stroke Foundation. Health service/ Health Service outcome cost per Explanation and costing assumptions Reference or Outcome person or day
The guidelines for use of paracetamol in NSW were adjusted to allow its use in stroke patients with a temperature of >37.5°C (updated from >38°C). Furthermore, the QASC Implementation Project found that participating trial sites were more likely to adhere to the hyperglycemia protocol (the protocol requiring the most amount of multidisciplinary teamwork) than sites that had not participated in the trial. Outcome Eligible participants if implemented Primary outcomes Secondary outcomes Clinical context Main clinical assumptions Treatment delivers better patient outcomes after discharge. Adults with stroke = 49,067 90 days after hospitalisation: death or dependency; functional dependency; mean mental & physical components. Processes of care: mean temperature; mean finger-prick blood glucose; proportion with swallowing screening undertaken; discharge diagnosis of aspiration pneumonia; LOS in hospital. The Fever, Sugar, Swallowing (FeSS) intervention has since been successfully implemented into 36 stroke services in NSW. The NSF clinical audit was also changed, and the NSW guidelines for paracetamol updated. Expect functional outcomes as based on Rankin score will capture the QALY impact of Barthel and SF-36 indices. Costing is based on Rankin score. Life expectancy based on Harald Hannerz et al. (2001). Proportion of patients excluded = 69% N= 15,211 Outcome Difference in risk between control and treatment N if implemented at 65% Health service cost per person or day Economic Impact on health service costs if implemented QALY impact per person Economic impact on QALYS if implemented Total Economic Impact Primary Functional outcomes at 3 months (Rankin scale score). Based on $ difference for treatment and QALY between treatment and control groups. -9,887 -$1,865 -$18m -$26,580 -$263m -$281m Change in intervention costs Totals +$0.6m -$18m -$263m -$281m Columns may not sum due to rounding. Negative values are savings in the calculations. LOS = length of stay. NSF = National Stroke Foundation. Health Service or Outcome Health service/ outcome cost per person or day Explanation and costing assumptions Reference
Supplementary-Appendix-B-Economic-evaluation-of-investigator-initiated-clinical-trials-conducted-by-networks.docx