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Home Programmes (home + programme)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Home programmes in paediatric occupational therapy for children with cerebral palsy: Where to start?

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 4 2006
Iona Novak
Aim:, Home programmes are used extensively for children with cerebral palsy. Even though there is consensus about the importance of home programme intervention, there is little evidence of efficacy and scant information regarding programme characteristics that might affect family participation. Instead, research to date has focussed on parental compliance with prescribed programmes and parent,child interactions. Methods:, Based on reviewed literature, this article proposes a model to guide development of home programmes for children with cerebral palsy. It is a starting point for therapists to consider the way in which they focus and structure their home programmes for children who have cerebral palsy. Results and Conclusions:, The paper identifies an urgent need to develop clinical guidelines for home programmes through rigorous formal processes and to evaluate the impact of occupational therapy home programmes. [source]

Cost-utility analysis of Canadian tailored prophylaxis, primary prophylaxis and on-demand therapy in young children with severe haemophilia A

HAEMOPHILIA, Issue 4 2008
N. RISEBROUGH
Summary. Primary prophylaxis is the emerging standard treatment for boys with severe haemophilia. Tailored (escalating-dose) prophylaxis (EscDose), beginning at a low frequency and escalating with repeated bleeding may prevent arthropathy at a lower cost than standard prophylaxis (SP). From a societal perspective, we compared the incremental cost per joint-haemorrhage that is avoided and quality-adjusted-life-year (QALY) gained of SP and EscDose to on-demand (Demand) therapy in severe haemophilia A boys treated to age 6 using a decision analytic model. Costs included factor VIII (FVIII), professional visits and tests, central venous placement/complications, hospitalization, home programmes and parents' lost work-days. Resource utilization was estimated by surveying 17 Canadian clinics. The natural history of bleeding and other probabilities were determined from a longitudinal chart review (n = 24) and published literature. EscDose costs an additional $3192 per joint-haemorrhage that was avoided compared with Demand whereas SP costs an additional $9046 per joint-haemorrhage that was avoided compared with EscDose. Clinic costs and lost wages were reduced by 60,80% for EscDose and SP compared with Demand. EscDose attained more QALYs than SP and Demand on account of less bleeding than Demand and lower need for ports than SP. The incremental cost per QALY for EscDose vs. Demand was $542 938. EscDose was less expensive with similar QALYs compared to SP. Sensitivity analysis was performed on all probability- and cost-estimates, and showed the model was sensitive to the cost of FVIII and the SP and target joint utilities. In conclusion, prophylaxis will substantially improve clinical outcomes and quality of life compared to Demand treatment, but with substantial cost. [source]