The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study

Mark Pennington, Howard Ring, James Howlett, Christopher Smith, Marcus Redley, Caroline Murphy, Roxanne Hook, Adam Platt, Nakita Gilbert, Elizabeth Jones, Joanna Kelly, Angela Pullen, Adrian Mander, Cam Donaldson, Simon Rowe, James Wason, Fiona Irvine

Research output: Contribution to journalArticle

Abstract

Background: The development of a nurse-led approach to managing epilepsy in adults with an intellectual disability offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of intellectual disability nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs.Method: Across the UK, 8 sites randomly allocated to the intervention recruited 184 participants, 9 sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after six months. Total costs at six months were compared from the perspective of health & social services, and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data was imputed using Multiple Imputation. Uncertainty was quantified by bootstrapping. Results: The intervention was associated with lower per participant costs from a health & social services perspective of -£357 (2014/15 GBP) (95% CI -£986, £294) and from a societal perspective of -£631 (95% CI -£1,473, £181). Results were not sensitive to the exclusion of accommodation costs.Conclusions: Our findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and intellectual disability and may reduce costs.
Original languageEnglish
Number of pages9
JournalJournal of Intellectual Disability Research
Early online date8 Aug 2019
DOIs
Publication statusE-pub ahead of print - 8 Aug 2019

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Intellectual Disability
Epilepsy
Nurses
Costs and Cost Analysis
Social Work
Competency
Costs
Disabled Persons
Health Care Costs
Uncertainty
Interviews
Health

Keywords

  • competency framework
  • cost
  • epilepsy
  • intellectual disability

Cite this

Pennington, Mark ; Ring, Howard ; Howlett, James ; Smith, Christopher ; Redley, Marcus ; Murphy, Caroline ; Hook, Roxanne ; Platt, Adam ; Gilbert, Nakita ; Jones, Elizabeth ; Kelly, Joanna ; Pullen, Angela ; Mander, Adrian ; Donaldson, Cam ; Rowe, Simon ; Wason, James ; Irvine, Fiona . / The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study. In: Journal of Intellectual Disability Research. 2019.
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abstract = "Background: The development of a nurse-led approach to managing epilepsy in adults with an intellectual disability offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of intellectual disability nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs.Method: Across the UK, 8 sites randomly allocated to the intervention recruited 184 participants, 9 sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after six months. Total costs at six months were compared from the perspective of health & social services, and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data was imputed using Multiple Imputation. Uncertainty was quantified by bootstrapping. Results: The intervention was associated with lower per participant costs from a health & social services perspective of -£357 (2014/15 GBP) (95{\%} CI -£986, £294) and from a societal perspective of -£631 (95{\%} CI -£1,473, £181). Results were not sensitive to the exclusion of accommodation costs.Conclusions: Our findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and intellectual disability and may reduce costs.",
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Pennington, M, Ring, H, Howlett, J, Smith, C, Redley, M, Murphy, C, Hook, R, Platt, A, Gilbert, N, Jones, E, Kelly, J, Pullen, A, Mander, A, Donaldson, C, Rowe, S, Wason, J & Irvine, F 2019, 'The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study', Journal of Intellectual Disability Research. https://doi.org/10.1111/jir.12679

The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study. / Pennington, Mark; Ring, Howard; Howlett, James; Smith, Christopher ; Redley, Marcus; Murphy, Caroline; Hook, Roxanne; Platt, Adam; Gilbert, Nakita; Jones, Elizabeth; Kelly, Joanna ; Pullen, Angela ; Mander, Adrian; Donaldson, Cam; Rowe, Simon ; Wason, James; Irvine, Fiona .

In: Journal of Intellectual Disability Research, 08.08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study

AU - Pennington, Mark

AU - Ring, Howard

AU - Howlett, James

AU - Smith, Christopher

AU - Redley, Marcus

AU - Murphy, Caroline

AU - Hook, Roxanne

AU - Platt, Adam

AU - Gilbert, Nakita

AU - Jones, Elizabeth

AU - Kelly, Joanna

AU - Pullen, Angela

AU - Mander, Adrian

AU - Donaldson, Cam

AU - Rowe, Simon

AU - Wason, James

AU - Irvine, Fiona

N1 - Acceptance in SAN AAM: 12m embargo Free access, not OA.

PY - 2019/8/8

Y1 - 2019/8/8

N2 - Background: The development of a nurse-led approach to managing epilepsy in adults with an intellectual disability offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of intellectual disability nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs.Method: Across the UK, 8 sites randomly allocated to the intervention recruited 184 participants, 9 sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after six months. Total costs at six months were compared from the perspective of health & social services, and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data was imputed using Multiple Imputation. Uncertainty was quantified by bootstrapping. Results: The intervention was associated with lower per participant costs from a health & social services perspective of -£357 (2014/15 GBP) (95% CI -£986, £294) and from a societal perspective of -£631 (95% CI -£1,473, £181). Results were not sensitive to the exclusion of accommodation costs.Conclusions: Our findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and intellectual disability and may reduce costs.

AB - Background: The development of a nurse-led approach to managing epilepsy in adults with an intellectual disability offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of intellectual disability nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs.Method: Across the UK, 8 sites randomly allocated to the intervention recruited 184 participants, 9 sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after six months. Total costs at six months were compared from the perspective of health & social services, and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data was imputed using Multiple Imputation. Uncertainty was quantified by bootstrapping. Results: The intervention was associated with lower per participant costs from a health & social services perspective of -£357 (2014/15 GBP) (95% CI -£986, £294) and from a societal perspective of -£631 (95% CI -£1,473, £181). Results were not sensitive to the exclusion of accommodation costs.Conclusions: Our findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and intellectual disability and may reduce costs.

KW - competency framework

KW - cost

KW - epilepsy

KW - intellectual disability

U2 - 10.1111/jir.12679

DO - 10.1111/jir.12679

M3 - Article

JO - Journal of Intellectual Disability Research

JF - Journal of Intellectual Disability Research

SN - 0964-2633

ER -