Abstract
Complex interventions are interventions or new healthcare technologies with many interacting components. Although most clinical trials could arguably be characterised as complex, the key distinguishing feature of complex interventions is that they involve the evaluation of multiple, potentially interacting components of an intervention, some of which may be challenging to measure or to systematically control. The challenge for evaluating complex interventions is then to design an evaluation that accounts for these different, interacting levels of care and their related social, environmental and individual factors so that one can tease out if the intervention is effective. This chapter provides guidance to researchers and health economists involved in the design and conduct of evaluations of complex interventions in end-of-life care.
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References
Taplin SH, Clauser S, Rodgers AB, Breslau E, Rayson D (2010) Interfaces across the cancer continuum offer opportunities to improve the process of care. J Natl Cancer Inst Monogr 2010(40):104–110, Epub 2010/04/14
Taplin SH, Anhang Price R, Edwards HM, Foster MK, Breslau ES, Chollette V et al (2012) Introduction: understanding and influencing multilevel factors across the cancer care continuum. J Natl Cancer Inst Monogr 2012(44):2–10, Epub 2012/05/25
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M (2008) Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 337:a1655
Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D et al (2000) Framework for design and evaluation of complex interventions to improve health. BMJ 321(7262):694–696
Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W et al (2015) Process evaluation of complex interventions: Medical Research Council guidance. BMJ 350:h1258
Challis D, von Abendorff R, Brown P, Chesterman J, Hughes J (2002) Care management, dementia care and specialist mental health services: an evaluation. Int J Geriatr Psychiatry 17(4):315–325, Epub 2002/05/08
Rubenstein LM, DeLeo A, Chrischilles EA (2001) Economic and health-related quality of life considerations of new therapies in Parkinson’s disease. PharmacoEconomics 19(7):729–752, Epub 2001/09/11
Round J (2012) Is a QALY still a QALY at the end of life? J Health Econ 31(3):521–527, Epub 2012/05/18
Round J, Sampson EL, Jones L (2014) A framework for understanding quality of life in individuals without capacity. Qual Life Res Int J Qual Life Asp Treat Care Rehab 23(2):477–484, Epub 2013/08/27
Thomas K (2003) Caring for the dying at home. Companions on a journey. Radcliffe Medical Press, Oxford
Neuberger J (2013) More care, less pathway. A review of the Liverpool Care Pathway. Department of Health. https://www.gov.uk/government/publications/review-of-liverpool-care-pathway-for-dying-patients
Evans CJ, Harding R, Higginson IJ (2013) ‘Best practice’ in developing and evaluating palliative and end-of-life care services: a meta-synthesis of research methods for the MORECare project. Palliat Med 27(10):885–898, Epub 2013/01/17
Hatziandreu E, Archontakis F, Daly A (2008) In: Office NA (ed) The potential cost savings of greater use of home- and hospice- based end of life care in England. RAND, Cambridge, UK
Eldridge S, Spencer A, Cryer C, Parsons S, Underwood M, Feder G (2005) Why modelling a complex intervention is an important precursor to trial design: lessons from studying an intervention to reduce falls-related injuries in older people. J Health Serv Res Policy 10(3):133–142, Epub 2005/08/02
Tappenden P, Chilcott JB, Eggington S, Oakley J, McCabe C (2004) Methods for expected value of information analysis in complex health economic models: developments on the health economics of interferon-beta and glatiramer acetate for multiple sclerosis. Health Technol Assess 8(27):iii, 1–78. Epub 2004/06/25
Briggs A, Sculpher M, Claxton K (2006) Decision modelling of health economic evaluation. Oxford University Press, Oxford
Drummond MF, Sculpher MJ, Torrence GW, O’Brien BJ, Stoddart GL (2005) Methods for the economic evaluation of health care programmes, 3rd edn. Oxford University Press, Oxford
McCrone P (2009) Capturing the costs of end-of-life care: comparisons of multiple sclerosis, Parkinson’s disease, and dementia. J Pain Symptom Manag 38(1):62–67, Epub 2009/07/21
Patel A, Rendu A, Moran P, Leese M, Mann A, Knapp M (2005) A comparison of two methods of collecting economic data in primary care. Fam Pract 22(3):323–327, Epub 2005/04/13
Wallihan DB, Stump TE, Callahan CM (1999) Accuracy of self-reported health services use and patterns of care among urban older adults. Med Care 37(7):662–670, Epub 1999/07/29
Rozario PA, Morrow-Howell N, Proctor E (2004) Comparing the congruency of self-report and provider records of depressed elders’ service use by provider type. Med Care 42(10):952–959, Epub 2004/09/21
Gage H, Cheynel J, Williams P, Mitchell K, Stinton C, Katz J et al (2015) Service utilisation and family support of people with dementia: a cohort study in England. Int J Geriatr Psychiatry 30(2):166–177
Chambless DL, Hollon SD (1998) Defining empirically supported therapies. J Consult Clin Psychol 66(1):7–18, Epub 1998/03/07
Burns T, Knapp M, Catty J, Healey A, Henderson J, Watt H et al (2001) Home treatment for mental health problems: a systematic review. Health Technol Assess 5(15):1–139, Epub 2001/09/05
Morris S, Hunter RM, Ramsay AI, Boaden R, McKevitt C, Perry C et al (2014) Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis. BMJ 349:g4757, Epub 2014/08/08
Angrist JD, Pischke J-S (2014) Mastering 'metrics: the path from cause to effect. Princeton University Press, Princeton
Gomes M, Ng ES, Grieve R, Nixon R, Carpenter J, Thompson SG (2012) Developing appropriate methods for cost-effectiveness analysis of cluster randomized trials. Med Decis Making Int J Soc Med Decis Making 32(2):350–361, Epub 2011/10/22
Hemming K, Haines TP, Chilton PJ, Girling AJ, Lilford RJ (2015) The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting. BMJ 350:h391, Epub 2015/02/11
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Hunter, R.M. (2016). The Role of the Health Economist in the Evaluation and Development of Complex Interventions in End-of-Life Care. In: Round, J. (eds) Care at the End of Life. Adis, Cham. https://doi.org/10.1007/978-3-319-28267-1_3
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DOI: https://doi.org/10.1007/978-3-319-28267-1_3
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