cost-effectiveness of self-managed program versus usual physiotherapy care of patients with knee osteoarthritis in nigeria

Objectives: this study aims to compare, from a patient’s perspective, the cost-effectiveness between a self-managed program and usual physiotherapy care in treating knee osteoarthritis. methods: the study participants were assigned into two groups: group i received a weekly physiotherapy treatment plus instructions on self- management skills in goal setting, pain management, exercise, healthy eating, and dealing with fatigue (self-managed group); group ii had a physiotherapy session three times a week (usual care group). the osteoarthritis cost and consequence and european quality of life-5 dimension (eq-5d) were used to generate utility scores. the health effects measure of quality-adjusted life year (qaly) was obtained, and an incremental cost-effective ratio was calculated. cost- effectiveness was determined by plotting a cost-effectiveness plane of incremental cost against qaly obtained. results: after 8 weeks of intervention, the self- managed group recorded more significant improvements in pain level, function, and health- related quality of life than the usual care group. clinical consultation costs (mean±sd ngn [nigerian naira]=1800±979), physiotherapy treatment costs (mean±sd ngn=4000±00), and transportation costs (mean±sd ngn=1,940±1,150) were less for the self- managed group than the usual care group. imaging (x-ray) and drug costs did not differ significantly between groups. the qalys gained over the 8-week intervention period was 0.13 for the self-management group compared to 0.11 for the usual care group. discussion: from the patient’s perspective, a self- managed program was cost-effective and cheaper for healthcare resource use. physiotherapists may adopt the program to reduce out-ofpocket expenses for patients with knee osteoarthritis.