Personalising adherence-enhancing interventions using a smart inhaler in patients with COPD: an exploratory cost-effectiveness analysis. Job FM van Boven Breda Cushen Imran Sulaiman Garrett Greene Elaine MacHale Matshediso Mokoka Frank Doyle Richard B. Reilly Kathleen Bennett Richard W. Costello 10779/rcsi.10784387.v1 https://repository.rcsi.com/articles/journal_contribution/Personalising_adherence-enhancing_interventions_using_a_smart_inhaler_in_patients_with_COPD_an_exploratory_cost-effectiveness_analysis_/10784387 <p>Four inhaler adherence clusters have been identified using the INCA audio device in COPD patients: (1) regular use/good technique, (2) regular use/frequent technique errors, (3) irregular use/good technique, and (4) irregular use/frequent technique errors. Their relationship with healthcare utilization and mortality was established, but the cost-effectiveness of adherence-enhancing interventions is unknown. In this exploratory study, we aimed to estimate the potential cost-effectiveness of reaching optimal adherence in the three suboptimal adherence clusters, i.e., a theoretical shift of clusters 2, 3, and 4 to cluster 1. Cost-effectiveness was estimated over a 5-year time horizon using the Irish healthcare payer perspective. We used a previously developed COPD health-economic model that was updated with INCA trial data and Irish national economic and epidemiological data. For each cluster, interventions would result in additional quality-adjusted life years gained at reasonable investment. Cost-effectiveness was most favorable in cluster 3, with possible cost savings of €845/annum/person.</p> 2019-11-22 16:29:35 COPD cost-effectiveness cost–utility health economics adherence. Medicine