Cost‐Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infection in Long‐Term Care Facilities: Economic Evaluation with a Randomized Controlled Trial. Issue 1 (January 2014)

• Record Type: Journal Article
• Authors: van den, Wilbert B.; Caljouw, Monique A. A.; Putter, Hein; Cools, Herman J. M.; Gussekloo, Jacobijn
• Is Part Of: Journal of the American Geriatrics Society. Volume 62:Issue 1(2014:Jan.)
• Page Start: 111
• Page End: 116
• Publication Date: 2014-01
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.12595
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" id="jgs12595-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs12595-sec-0001" sec-type="section"> <title>Objectives</title> <p>To investigate whether the preventive use of cranberry capsules in long‐term care facility (LTCF) residents is cost‐effective depending on urinary tract infection (UTI) risk.</p> </sec> <sec id="jgs12595-sec-0002" sec-type="section"> <title>Design</title> <p>Economic evaluation with a randomized controlled trial.</p> </sec> <sec id="jgs12595-sec-0003" sec-type="section"> <title>Setting</title> <p>Long‐term care facilities.</p> </sec> <sec id="jgs12595-sec-0004" sec-type="section"> <title>Participants</title> <p>LTCF residents (N = 928, 703 female, median age 84), stratified according to UTI risk.</p> </sec> <sec id="jgs12595-sec-0005" sec-type="section"> <title>Measurements</title> <p>UTI incidence (clinically or strictly defined), survival, quality of life, quality‐adjusted life years (QALYs), and costs.</p> </sec> <sec id="jgs12595-sec-0006" sec-type="section"> <title>Results</title> <p>In the weeks after a clinical UTI, participants showed a significant but moderate deterioration in quality of life, survival, care dependency, and costs. In high‐UTI‐risk participants, cranberry costs were estimated at €439 per year (1.00 euro = 1.37 U.S. dollar), which is €3, 800 per prevented clinically defined UTI (95% confidence interval = €1, 300–infinity). Using the strict UTI definition, the use of cranberry increased costs without preventing UTIs. Taking cranberry capsules had a 22% probability of being cost‐effective compared with placebo (at a willingness to pay of €40, 000 per QALY). In low‐UTI‐risk participants, use of cranberry capsules was only 3% likely to be cost‐effective.</p> </sec> <sec id="jgs12595-sec-0007" sec-type="section"> <title>Conclusion</title> <p>In high‐UTI‐risk residents, taking cranberry capsules may be effective in preventing UTIs but is not likely to be cost‐effective in the investigated dosage, frequency, and setting. In low‐UTI‐risk LTCF residents, taking cranberry capsules twice daily is neither effective nor cost‐effective.</p> </sec> </abstract>