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A pilot economic evaluation of a feasibility trial for SUpporting wellbeing through PEeR-Befriending (SUPERB) for post-stroke aphasia

Flood, C., Behn, N. ORCID: 0000-0001-9356-9957, Marshall, J. ORCID: 0000-0002-6589-221X , Simpson, A. ORCID: 0000-0003-3286-9846, Northcott, S. ORCID: 0000-0001-8229-5452, Thomas, S., Goldsmith, K., McVicker, S., Jofre-Bonet, M. ORCID: 0000-0002-2055-2166 & Hilari, K. ORCID: 0000-0003-2091-4849 (2022). A pilot economic evaluation of a feasibility trial for SUpporting wellbeing through PEeR-Befriending (SUPERB) for post-stroke aphasia. Clinical Rehabilitation, doi: 10.1177/02692155211063554

Abstract

Objectives
To explore the feasibility of a full economic evaluation of usual care plus peer-befriending versus usual care control, and potential cost-effectiveness of peer-befriending for people with aphasia. To report initial costs, ease of instruments’ completion and overall data completeness.

Design
Pilot economic evaluation within a feasibility randomised controlled trial

Setting
Community, England

Participants
People with post-stroke aphasia and low levels of psychological distress

Intervention
All participants received usual care; intervention participants received six peer-befriending visits between randomisation and four months

Main measures
Costs were collected on the stroke-adapted Client Service Receipt Inventory (CSRI) for health, social care and personal out-of-pocket expenditure arising from care for participants and carers at 4- and 10-months post-randomisation. Health gains and costs were reported using the General Health Questionnaire-12 and the EQ-5D-5L. Mean (CI) differences for costs and health gains were reported and uncertainty represented using non-parametric bootstrapping and cost-effectiveness acceptability curves.

Results
56 participants were randomised. Mean age was 70.1 (SD 13.4). Most (n = 37, 66%) had mild and many (n = 14; 25%) severe aphasia. There was ≥94% completion of CSRI questions. Peer-befriending was higher in intervention arm (p < 0.01) but there were no significant differences in total costs between trial arms. Peer-befriending visits costed on average £57.24 (including training and supervision costs). The probability of peer-befriending being cost-effective ranged 39% to 66%.

Conclusions
Economic data can be collected from participants with post-stroke aphasia, indicating a full economic evaluation within a definitive trial is feasible. A larger study is needed to demonstrate further cost-effectiveness of peer-befriending.

Publication Type: Article
Additional Information: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Publisher Keywords: Economic evaluation, feasibility study, peer-befriending, stroke, aphasia, mood
Subjects: H Social Sciences > HC Economic History and Conditions
P Language and Literature > P Philology. Linguistics
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Departments: School of Policy & Global Affairs > Economics
School of Health & Psychological Sciences > Language & Communication Science
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