Could Home Sexually Transmitted Infection Specimen Collection With e-Prescription Be a Cost-Effective Strategy for Clinical Trials and Clinical Care?

被引：21

作者：

Blake, Diane R. ^{[1
]}

Spielberg, Freya ^{[2
]}

Levy, Vivian ^{[3
,4
]}

Lensing, Shelly ^{[5
]}

Wolff, Peter A. ^{[6
]}

Venkatasubramanian, Lalitha ^{[7
]}

Acevedo, Nincoshka ^{[7
]}

Padian, Nancy ^{[8
]}

Chattopadhyay, Ishita ^{[2
]}

Gaydos, Charlotte A. ^{[9
]}

机构：

[1] Univ Massachusetts, Sch Med, Dept Pediat, Worcester, MA 01655 USA

[2] George Washington Univ, Sch Publ Hlth, Dept Prevent & Community Hlth, Washington, DC USA

[3] San Mateo Cty Hlth Syst, San Mateo, CA USA

[4] Stanford Univ, Div Infect Dis, Stanford, CA 94305 USA

[5] Univ Arkansas Med Sci, Dept Biostat, Little Rock, AR 72205 USA

[6] NIAID, NIH, Bethesda, MD 20892 USA

[7] FHI360, Durham, NC USA

[8] Univ Calif Berkeley, Div Epidemiol, Berkeley, CA 94720 USA

[9] Johns Hopkins Univ, Dept Med, Div Infect Dis, Baltimore, MD USA

来源：

SEXUALLY TRANSMITTED DISEASES | 2015年 / 42卷 / 01期

关键词：

CHLAMYDIA; INTERNET;

D O I：

10.1097/OLQ.0000000000000221

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Results of a recent demonstration project evaluating feasibility, acceptability, and cost of a Web-based sexually transmitted infection (STI) testing and e-prescription treatment program (eSTI) suggest that this approach could be a feasible alternative to clinic-based testing and treatment, but the results need to be confirmed by a randomized comparative effectiveness trial. Methods: We modeled a decision tree comparing (1) cost of eSTI screening using a home collection kit and an e-prescription for uncomplicated treatment versus (2) hypothetical costs derived from the literature for referral to standard clinic-based STI screening and treatment. Primary outcome was number of STIs detected. Analyses were conducted from the clinical trial perspective and the health care system perspective. Results: The eSTI strategy detected 75 infections, and the clinic referral strategy detected 45 infections. Total cost of eSTI was $94,938 ($1266/STI detected) from the clinical trial perspective and $96,088 ($1281/STI detected) from the health care system perspective. Total cost of clinic referral was $87,367 ($1941/STI detected) from the clinical trial perspective and $71,668 ($1593/STI detected) from the health care system perspective. Conclusions: Results indicate that eSTI will likely be more cost-effective (lower cost/STI detected) than clinic-based STI screening, both in the context of clinical trials and in routine clinical care. Although our results are promising, they are based on a demonstration project and estimates from other small studies. A comparative effectiveness research trial is needed to determine actual cost and impact of the eSTI system on identification and treatment of new infections and prevention of their sequelae.

引用

页码：13 / 19

页数：7