TY - JOUR
T1 - Cost-effectiveness of a nurse-led sexual rehabilitation intervention for women treated with radiotherapy for gynaecological cancer in a randomized trial
AU - Suvaal, Isabelle
AU - van den Hout, Wilbert B
AU - Hummel, Susanna B
AU - Mens, Jan-Willem M
AU - Tuijnman-Raasveld, Charlotte C
AU - Velema, Laura A
AU - Westerveld, Henrike
AU - Cnossen, Jeltsje S
AU - Snyers, An
AU - Jürgenliemk-Schulz, Ina M
AU - Lutgens, Ludy C H W
AU - Beukema, Jannet C
AU - Haverkort, Marie A D
AU - Nowee, Marlies E
AU - Nout, Remi A
AU - de Kroon, Cor D
AU - van Doorn, Helena C
AU - Creutzberg, Carien L
AU - Ter Kuile, Moniek M
N1 - Copyright © 2024. Published by Elsevier B.V.
PY - 2025/2
Y1 - 2025/2
N2 - PURPOSE: To compare the cost-effectiveness of a nurse-led sexual rehabilitation intervention with standard care in women treated with external beam radiotherapy, with or without brachytherapy, for gynaecological cancers.METHODS: Eligible women were randomly assigned to the intervention (n = 112) or standard care (n = 117). Primary endpoint was sexual functioning at 12-months post-radiotherapy, assessed by the Female Sexual Function Index (FSFI). Nurses documented frequency and duration of intervention sessions, patients reported sexual healthcare and functioning at 1, 3, 6, and 12-months. Costs were related to quality-adjusted-life-years (QALYs) using the EuroQol-5 Dimensions and visual analogue scale, and to sexual functioning improvement at 12-months. T-tests compared mean QALYs and costs, with multiple imputation for missing data.RESULTS: The nurse-led intervention added €172 per patient, including training costs and 4-5 sessions. Other sexual rehabilitation costs were higher in the standard care group (€107 versus €141, p = 0.02). Total costs were €478 for the intervention group and €357 for standard care (p = 0.03). Valued at €20.000 per QALY, the intervention was 60 %-70 % likely to be cost-effective and less than 50 % likely to be cost-effective in terms of improved sexual functioning.CONCLUSION: The nurse-led sexual rehabilitation intervention is not more cost-effective than standard care, however with low costs in both groups. Since costs for standard care were slightly lower, it is preferred from a health-economic perspective. It includes detailed patient education and a dedicated sexual rehabilitation session within the first three months post-radiotherapy, which is better provided at lower cost by a trained nurse.
AB - PURPOSE: To compare the cost-effectiveness of a nurse-led sexual rehabilitation intervention with standard care in women treated with external beam radiotherapy, with or without brachytherapy, for gynaecological cancers.METHODS: Eligible women were randomly assigned to the intervention (n = 112) or standard care (n = 117). Primary endpoint was sexual functioning at 12-months post-radiotherapy, assessed by the Female Sexual Function Index (FSFI). Nurses documented frequency and duration of intervention sessions, patients reported sexual healthcare and functioning at 1, 3, 6, and 12-months. Costs were related to quality-adjusted-life-years (QALYs) using the EuroQol-5 Dimensions and visual analogue scale, and to sexual functioning improvement at 12-months. T-tests compared mean QALYs and costs, with multiple imputation for missing data.RESULTS: The nurse-led intervention added €172 per patient, including training costs and 4-5 sessions. Other sexual rehabilitation costs were higher in the standard care group (€107 versus €141, p = 0.02). Total costs were €478 for the intervention group and €357 for standard care (p = 0.03). Valued at €20.000 per QALY, the intervention was 60 %-70 % likely to be cost-effective and less than 50 % likely to be cost-effective in terms of improved sexual functioning.CONCLUSION: The nurse-led sexual rehabilitation intervention is not more cost-effective than standard care, however with low costs in both groups. Since costs for standard care were slightly lower, it is preferred from a health-economic perspective. It includes detailed patient education and a dedicated sexual rehabilitation session within the first three months post-radiotherapy, which is better provided at lower cost by a trained nurse.
U2 - 10.1016/j.radonc.2024.110683
DO - 10.1016/j.radonc.2024.110683
M3 - Article
C2 - 39675572
SN - 0167-8140
VL - 203
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 110683
ER -