An Economic Evaluation of a Web-Based Management Support System for Children With Urinary Incontinence: The eADVICE Trial

No AccessJournal of UrologyPediatric Article11 Apr 2024An Economic Evaluation of a Web-Based Management Support System for Children With Urinary Incontinence: The eADVICE Trial Amy Von Huben, Martin Howell, Deborah Richards, Sana Hamilton, Kirsten Howard, Armando Teixeira-Pinto, Jonathan C. Craig, Chris Seton, Karen Waters, Aniruddh Deshpande, Karen M. Scott, and Patrina H. Y. Caldwell Amy Von HubenAmy Von Huben Corresponding Author: Amy Von Huben, Menzies Centre for Health Policy and Economics, The University of Sydney, Level 2, Charles Perkins Centre D17, Camperdown, NSW 2006, Australia ( (email protected) ). https: //orcid. org/0000-0001-6168-9719, Martin HowellMartin Howell https: //orcid. org/0000-0001-9740-712X, Deborah RichardsDeborah Richards https: //orcid. org/0000-0002-7363-1511, Sana HamiltonSana Hamilton https: //orcid. org/0009-0005-1488-6767, Kirsten HowardKirsten Howard https: //orcid. org/0000-0002-0918-7540, Armando Teixeira-PintoArmando Teixeira-Pinto https: //orcid. org/0000-0002-9389-2516, Jonathan C. CraigJonathan C. Craig https: //orcid. org/0000-0002-2548-4035, Chris SetonChris Seton, Karen WatersKaren Waters https: //orcid. org/0000-0001-8699-2175, Aniruddh DeshpandeAniruddh Deshpande https: //orcid. org/0000-0001-7303-9131, Karen M. ScottKaren M. Scott https: //orcid. org/0000-0003-0721-6675, and Patrina H. Y. CaldwellPatrina H. Y. Caldwell https: //orcid. org/0000-0003-1124-6578 View All Author Informationhttps: //doi. org/10. 1097/JU. 0000000000003970AboutPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Children who require specialist outpatient care typically wait substantial periods during which their condition may progress, making treatment more difficult and costly. Timely and effective therapy during this period may reduce the need for lengthy specialist care. This study evaluated the cost-effectiveness of an individualized, evidence-informed, web-based program for children with urinary incontinence awaiting a specialist appointment (eADVICE) compared to usual care. eADVICE was supervised by a primary physician and delivered by an embodied conversational agent (ECA). Materials and Methods: A trial-based cost-effectiveness analysis was performed from the perspective of the healthcare funder as a sub-study of eADVICE, a multicenter waitlist-controlled randomized trial. Outcomes measures were incremental cost per incremental change in continence status and quality of life on an intention-to-treat basis. Uncertainty was examined using cost-effectiveness planes, scenarios, and 1-way sensitivity analyses. Costs were valued in 2021 Australian dollars (). Results: The use of eADVICE was found to be cost-saving and beneficial (dominant) over usual care, with a higher proportion of children dry over 14 days at 6 months (RD 0. 13; 95%CI 0. 02-0. 23, P =. 03) and mean healthcare costs reduced by 188 (95%CI 61-315) per participant. Conclusion: An individualized, evidence-informed web-based program delivered by an ECA is likely cost-saving for children with urinary incontinence awaiting a specialist appointment. The potential economic impact of such a program is favorable and substantial and may be transferable to outpatient clinic settings for other chronic health conditions. © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Keywordsenuresisurinary incontinencechildrentelemedicineeconomic evaluationMetrics Author Information Amy Von Huben Corresponding Author: Amy Von Huben, Menzies Centre for Health Policy and Economics, The University of Sydney, Level 2, Charles Perkins Centre D17, Camperdown, NSW 2006, Australia ( (email protected) ). More articles by this author Martin Howell More articles by this author Deborah Richards More articles by this author Sana Hamilton More articles by this author Kirsten Howard More articles by this author Armando Teixeira-Pinto More articles by this author Jonathan C. Craig More articles by this author Chris Seton More articles by this author Karen Waters More articles by this author Aniruddh Deshpande More articles by this author Karen M. Scott More articles by this author Patrina H. Y. Caldwell More articles by this author Expand All Advertisement PDF downloadLoading. . .