Task-shifting alcohol interventions for HIV+ persons in Kenya: a cost-benefit analysis.
Identifieur interne : 000982 ( PubMed/Corpus ); précédent : 000981; suivant : 000983Task-shifting alcohol interventions for HIV+ persons in Kenya: a cost-benefit analysis.
Auteurs : Omar Galárraga ; Burke Gao ; Benson N. Gakinya ; Debra A. Klein ; Richard G. Wamai ; John E. Sidle ; Rebecca K. PapasSource :
- BMC health services research [ 1472-6963 ] ; 2017.
English descriptors
- KwdEn :
- Adult, Alcohol Drinking (prevention & control), Alcoholism (complications), Alcoholism (economics), Alcoholism (therapy), Allied Health Personnel (economics), Allied Health Personnel (education), Cognitive Therapy (economics), Cost-Benefit Analysis, HIV Infections (epidemiology), HIV Infections (etiology), HIV Infections (prevention & control), Humans, Incidence, Kenya (epidemiology), Risk Factors.
- MESH :
- complications : Alcoholism.
- economics : Alcoholism, Allied Health Personnel, Cognitive Therapy.
- education : Allied Health Personnel.
- epidemiology : HIV Infections, Kenya.
- etiology : HIV Infections.
- prevention & control : Alcohol Drinking, HIV Infections.
- therapy : Alcoholism.
- Adult, Cost-Benefit Analysis, Humans, Incidence, Risk Factors.
Abstract
Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms.
DOI: 10.1186/s12913-017-2169-4
PubMed: 28351364
Links to Exploration step
pubmed:28351364Le document en format XML
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Gakinya</name><affiliation><nlm:affiliation>Moi University & Moi Teaching and Referral Hospital, Nandi Rd, Eldoret, Kenya.</nlm:affiliation></affiliation></author><author><name sortKey="Klein, Debra A" sort="Klein, Debra A" uniqKey="Klein D" first="Debra A" last="Klein">Debra A. Klein</name><affiliation><nlm:affiliation>Edify Youth, St Paul, MN, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Wamai, Richard G" sort="Wamai, Richard G" uniqKey="Wamai R" first="Richard G" last="Wamai">Richard G. Wamai</name><affiliation><nlm:affiliation>Northeastern University, Integrated Initiative for Global Health, 360 Huntington Avenue, 220G RP, Boston, MA, 02115, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Sidle, John E" sort="Sidle, John E" uniqKey="Sidle J" first="John E" last="Sidle">John E. Sidle</name><affiliation><nlm:affiliation>Indiana University School of Medicine, Indianapolis, IN, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Papas, Rebecca K" sort="Papas, Rebecca K" uniqKey="Papas R" first="Rebecca K" last="Papas">Rebecca K. Papas</name><affiliation><nlm:affiliation>Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, 02912, USA. rebecca_papas@brown.edu.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28351364</idno><idno type="pmid">28351364</idno><idno type="doi">10.1186/s12913-017-2169-4</idno><idno type="wicri:Area/PubMed/Corpus">000982</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000982</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Task-shifting alcohol interventions for HIV+ persons in Kenya: a cost-benefit analysis.</title><author><name sortKey="Galarraga, Omar" sort="Galarraga, Omar" uniqKey="Galarraga O" first="Omar" last="Galárraga">Omar Galárraga</name><affiliation><nlm:affiliation>Brown University School of Public Health, G-S121-7, 121 South Main Street, Providence, RI, 02912, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Gao, Burke" sort="Gao, Burke" uniqKey="Gao B" first="Burke" last="Gao">Burke Gao</name><affiliation><nlm:affiliation>Brown University School of Public Health, G-S121-7, 121 South Main Street, Providence, RI, 02912, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Gakinya, Benson N" sort="Gakinya, Benson N" uniqKey="Gakinya B" first="Benson N" last="Gakinya">Benson N. Gakinya</name><affiliation><nlm:affiliation>Moi University & Moi Teaching and Referral Hospital, Nandi Rd, Eldoret, Kenya.</nlm:affiliation></affiliation></author><author><name sortKey="Klein, Debra A" sort="Klein, Debra A" uniqKey="Klein D" first="Debra A" last="Klein">Debra A. Klein</name><affiliation><nlm:affiliation>Edify Youth, St Paul, MN, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Wamai, Richard G" sort="Wamai, Richard G" uniqKey="Wamai R" first="Richard G" last="Wamai">Richard G. Wamai</name><affiliation><nlm:affiliation>Northeastern University, Integrated Initiative for Global Health, 360 Huntington Avenue, 220G RP, Boston, MA, 02115, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Sidle, John E" sort="Sidle, John E" uniqKey="Sidle J" first="John E" last="Sidle">John E. Sidle</name><affiliation><nlm:affiliation>Indiana University School of Medicine, Indianapolis, IN, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Papas, Rebecca K" sort="Papas, Rebecca K" uniqKey="Papas R" first="Rebecca K" last="Papas">Rebecca K. Papas</name><affiliation><nlm:affiliation>Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, 02912, USA. rebecca_papas@brown.edu.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMC health services research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Alcohol Drinking (prevention & control)</term><term>Alcoholism (complications)</term><term>Alcoholism (economics)</term><term>Alcoholism (therapy)</term><term>Allied Health Personnel (economics)</term><term>Allied Health Personnel (education)</term><term>Cognitive Therapy (economics)</term><term>Cost-Benefit Analysis</term><term>HIV Infections (epidemiology)</term><term>HIV Infections (etiology)</term><term>HIV Infections (prevention & control)</term><term>Humans</term><term>Incidence</term><term>Kenya (epidemiology)</term><term>Risk Factors</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Alcoholism</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Alcoholism</term><term>Allied Health Personnel</term><term>Cognitive Therapy</term></keywords><keywords scheme="MESH" qualifier="education" xml:lang="en"><term>Allied Health Personnel</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>HIV Infections</term><term>Kenya</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Alcohol Drinking</term><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Alcoholism</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cost-Benefit Analysis</term><term>Humans</term><term>Incidence</term><term>Risk Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28351364</PMID><DateCreated><Year>2017</Year><Month>03</Month><Day>29</Day></DateCreated><DateCompleted><Year>2017</Year><Month>09</Month><Day>11</Day></DateCompleted><DateRevised><Year>2017</Year><Month>09</Month><Day>11</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1472-6963</ISSN><JournalIssue CitedMedium="Internet"><Volume>17</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>Mar</Month><Day>28</Day></PubDate></JournalIssue><Title>BMC health services research</Title><ISOAbbreviation>BMC Health Serv Res</ISOAbbreviation></Journal><ArticleTitle>Task-shifting alcohol interventions for HIV+ persons in Kenya: a cost-benefit analysis.</ArticleTitle><Pagination><MedlinePgn>239</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12913-017-2169-4</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a cost-benefit analysis, measuring economic return on investment, of a task-shifted cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use in a modeled cohort of 13,440 outpatients in Kenya. In our base-case, we estimated the costs and economic benefits from a societal perspective across a six-year time horizon, with a 3% annual discount rate. Costs included all costs associated with training and administering task-shifted CBT therapy. Benefits included the economic impact of lowered HIV incidence as well as the improvements in household and labor-force productivity. We conducted univariate and multivariate probabilistic sensitivity analyses to test the robustness of our results.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Under the base case, total costs for CBT rollout was $554,000, the value of benefits were $628,000, and the benefit-to-cost ratio was 1.13. Sensitivity analyses showed that under most assumptions, the benefit-to-cost ratio remained above unity indicating that the intervention was cost-saving (i.e., had positive return on investment). The duration of the treatment effect most effected the results in sensitivity analyses.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">CBT can be effectively and economically task-shifted to paraprofessionals in Kenya. The intervention can generate not only reductions in morbidity and mortality, but also economic savings for the health system in the medium and long term. The findings have implications for other countries with generalized HIV epidemics, high prevalence of alcohol consumption, and shortages of mental health professionals.</AbstractText><AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">This paper uses data derived from "Cognitive Behavioral Treatment to Reduce Alcohol Use Among HIV-Infected Kenyans (KHBS)" with ClinicalTrials.gov registration NCT00792519 on 11/17/2008; and preliminary data from "A Stage 2 Cognitive-behavioral Trial: Reduce Alcohol First in Kenya Intervention" ( NCT01503255 , registered on 12/16/2011).</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Galárraga</LastName><ForeName>Omar</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Brown University School of Public Health, G-S121-7, 121 South Main Street, Providence, RI, 02912, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gao</LastName><ForeName>Burke</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Brown University School of Public Health, G-S121-7, 121 South Main Street, Providence, RI, 02912, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Brown University Alpert Medical School, 222 Richmond Street, Providence, RI, 02912, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gakinya</LastName><ForeName>Benson N</ForeName><Initials>BN</Initials><AffiliationInfo><Affiliation>Moi University & Moi Teaching and Referral Hospital, Nandi Rd, Eldoret, Kenya.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klein</LastName><ForeName>Debra A</ForeName><Initials>DA</Initials><AffiliationInfo><Affiliation>Edify Youth, St Paul, MN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wamai</LastName><ForeName>Richard G</ForeName><Initials>RG</Initials><AffiliationInfo><Affiliation>Northeastern University, Integrated Initiative for Global Health, 360 Huntington Avenue, 220G RP, Boston, MA, 02115, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sidle</LastName><ForeName>John E</ForeName><Initials>JE</Initials><AffiliationInfo><Affiliation>Indiana University School of Medicine, Indianapolis, IN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Papas</LastName><ForeName>Rebecca K</ForeName><Initials>RK</Initials><AffiliationInfo><Affiliation>Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, 02912, USA. rebecca_papas@brown.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R24 HD041020</GrantID><Acronym>HD</Acronym><Agency>NICHD NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType 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MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000488" MajorTopicYN="Y">Allied Health Personnel</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000193" MajorTopicYN="N">education</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015928" MajorTopicYN="N">Cognitive Therapy</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007630" MajorTopicYN="N">Kenya</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">AIDS</Keyword><Keyword MajorTopicYN="N">Alcohol</Keyword><Keyword MajorTopicYN="N">CBT</Keyword><Keyword MajorTopicYN="N">Cognitive-behavioral-therapy</Keyword><Keyword MajorTopicYN="N">Cost-benefit-analysis</Keyword><Keyword MajorTopicYN="N">HIV</Keyword><Keyword MajorTopicYN="N">Kenya</Keyword><Keyword MajorTopicYN="N">Sub-Saharan Africa</Keyword><Keyword MajorTopicYN="N">Task-shifting</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>12</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>03</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>3</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>3</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>9</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28351364</ArticleId><ArticleId IdType="doi">10.1186/s12913-017-2169-4</ArticleId><ArticleId IdType="pii">10.1186/s12913-017-2169-4</ArticleId><ArticleId 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