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Research

Pressure relieving support surfaces (PRESSURE) trial: cost effectiveness analysis

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.38850.711435.7C (Published 15 June 2006) Cite this as: BMJ 2006;332:1416

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  1. Cynthia Iglesias, research fellow1,
  2. Jane Nixon, deputy director2,
  3. Gillian Cranny, research fellow3,
  4. E Andrea Nelson, reader4,
  5. Kim Hawkins, assistant director (statistics)2,
  6. Angela Phillips, senior trial coordinator2,
  7. David Torgerson, professor1,
  8. Su Mason, principal research fellow2,
  9. Nicky Cullum, professor, PRESSURE Trial Group (nac2{at}york.ac.uk)1
  1. 1 Department of Health Sciences, University of York, York YO10 5DD
  2. 2 Clinical Trials Research Unit, University of Leeds
  3. 3 Centre for Reviews and Dissemination, University of York
  4. 4 School of Healthcare Studies, University of Leeds
  1. Correspondence to: N Cullum
  • Accepted 24 March 2006

Abstract

Objective To assess the cost effectiveness of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers in patients admitted to hospital.

Design Cost effectiveness analysis carried out alongside the pressure relieving support surfaces (PRESSURE) trial; a multicentre UK based pragmatic randomised controlled trial.

Setting 11 hospitals in six UK NHS trusts.

Participants Intention to treat population comprising 1971 participants.

Main outcome measures Kaplan Meier estimates of restricted mean time to development of pressure ulcers and total costs for treatment in hospital.

Results Alternating pressure mattresses were associated with lower overall costs (£283.6 per patient on average, 95% confidence interval - £377.59 to £976.79) mainly due to reduced length of stay in hospital, and greater benefits (a delay in time to ulceration of 10.64 days on average, - 24.40 to 3.09). The differences in health benefits and total costs for hospital stay between alternating pressure mattresses and alternating pressure overlays were not statistically significant; however, a cost effectiveness acceptability curve indicated that on average alternating pressure mattresses compared with alternating pressure overlays were associated with an 80% probability of being cost saving.

Conclusion Alternating pressure mattresses for the prevention of pressure ulcers are more likely to be cost effective and are more acceptable to patients than alternating pressure overlays.

Footnotes

  • Contributors NC, JN, AN, SM, and DT designed and initiated the trial. JN, AP, and HB coordinated the trial. GC and KH analysed the clinical data. CI and DT analysed the economic data. All authors met regularly and contributed to trial management; all participated in the interpretation of results and approved the paper. NC is the guarantor.

  • Funding UK Department of Health through its health technology assessment programme. The opinions and conclusions expressed here are those of the authors and do not necessarily reflect those of the UK NHS or the Department of Health.

  • Competing interests JN has been reimbursed for attending conferences, has been paid speakers' fees, and received research funding from Huntleigh Healthcare.

  • Ethical approval This study was approved by the North West multicentre research ethics committee and local ethics committees.

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