Key result
My Therapy self-management program shows no benefit over usual care for improving functional independence.
Why the study?
To determine whether the My Therapy self-management program could be implemented without increasing rehabilitation admission costs from a health service perspective.
Does the My Therapy self-directed therapy program improve functional independence and quality-adjusted life years without increasing costs in rehabilitation inpatients?
RCT (n=2,363)
Stepped wedge cluster
Yes
Does the My Therapy self-directed therapy program improve functional independence and quality-adjusted life years without increasing costs in rehabilitation inpatients?
The My Therapy self-management program was implemented without increasing rehabilitation admission and all-cause 30-day readmission costs, but clinical differences in function and quality of life were not detected.
No functional benefit from My Therapy in rehabilitation inpatients; confirms usual care suffices without added costs.
Objective To determine if the My Therapy self-management program could be implemented without increasing the rehabilitation admission cost, from a health service perspective. Design Economic evaluation, including a cost-effectiveness analysis. Setting Australian rehabilitation wards ( n = 9). Participants Rehabilitation inpatients with any diagnosis. Intervention My Therapy: a self-directed therapy program shown to increase daily inpatient rehabilitation participation dosage time by 38%. Main Measures Outcomes included cost (rehabilitation admission and all-cause 30-day readmissions), and effect (minimal clinically important difference in functional independence (FIM TM ), and quality-adjusted life years (EQ-5D-5L)), to estimate incremental cost-effectiveness ratios (ICERs). Results There were 2363 participants, with a mean age of 77 (SD 13) years, 62% female, and 27% with cognitive impairment. My Therapy costs $5 (SD $2) per patient/day to implement, excluding opportunity costs. Estimated differences in effect were non-significant for the proportion of participants achieving a minimal clinically important difference in function (control 31%, intervention 36%; OR: 1.08, 95% CI: 0.77, 1.53), and quality-adjusted life years (mean difference −0.01, 95% CI: −0.04 to 0.02). Estimated differences in cost were also non-significant (OR: 1.06, 95% CI: 0.97, 1.16). ICERs were also non-significant. Post hoc, it was determined that the cost/minute of daily therapy participation was $14/minute for control and $11/minute for intervention conditions. Conclusions The My Therapy self-management program was implemented without increasing rehabilitation admission and all-cause 30-day readmission costs. However, clinical differences were not detected. There may have been a small reduction in cost/minute for daily therapy participation.
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Brusco et al. (2025) conducted an RCT in Rehabilitation inpatients (n=2,363). My Therapy self-directed therapy program vs. Usual care was evaluated on Minimal clinically important difference in functional independence (FIM) (OR 1.08, 95% CI 0.77-1.53, p=0.64). The My Therapy self-management program did not significantly increase the proportion of participants achieving a minimal clinically important difference in function (OR 1.08) or increase rehabilitation admission costs compared to usual care.
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