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Cost-effectiveness of parent-training intervention for managing sleep problems in children with neurodevelopment disorders

Onivefu Odelade, London School of Economics

Research objective 

The central objective which my proposed research topic aims to achieve is to analyse the cost-effectiveness (or possibly the cost-utility) of parent-training interventions (alone or combined with melatonin) for managing sleep problems in children with neurodevelopmental disorders compared to treatment with melatonin.   

Through this research, I am hoping to answer the following questions: 

  • Are parent-training interventions (alone or in combination with melatonin) for managing sleep problems in children with neurodevelopmental disorders cost effective?  Is this intervention more cost effective than the current common practice of treating with melatonin? 
  • In order to provide a broader context to make judgements about the value for money, what incremental costs to gain an extra quality-adjusted-life-year (QALY) are associated with parent-training interventions (alone or in combination with melatonin) for managing sleep problems in children with neurodevelopmental disorders compared to treating with melatonin? 
  • What form of parent training intervention is reported to be the most clinically effective in managing sleep problems in children with neurodevelopmental disorders? 
  • Is health economic modelling useful in Clinical Commissioning Groups’ medicines optimisation and commissioning decision making / priority setting process?   

The dissertation proposal was approved in February 2018 by the University, further refining of the project will begin shortly.   

Sources of data and methods to be used in the research 

  • Study design:  Cost effectiveness / cost utility modelling either using decision tree or using a Markov model.   Economic costs and effects will be calculated from the perspective of the payer.    
  • Comparators: Parent-training intervention programme (alone or in combination with melatonin) vs melatonin only. 
  • Health condition specific data: Prevalence of sleep disorders in children with neurodevelopmental disorders, transition states will be obtained via NHS data sets and/or evidence from previous studies.  
  • Effectiveness: Effectiveness data will be obtained from relevant studies to estimate sleep improvement (e.g. time taken to fall asleep, time spent sleeping), years of life gained and quality of life years gained. 
  • Costs: Costs related to parent training interventions such as staff costs, service costs, will be obtained via NHS data sets, other studies, interviews with key commissioners and/or providers.  Prescribing costs of melatonin in England will be obtained via ePACT prescribing database.     
  • Uncertain variables will be subjected to sensitivity analysis.   
  • A literature review will be undertaken to determine the design of parent training intervention with the most clinical evidence supporting its use, its associated costs and effectiveness.

The project ran from August 2017 to August 2018.

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