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Cost-effectiveness of adherence interventions in resource-poor countries?

By Hannah Mogul-Adlin | 29 Jun, 2009

Hi everyone,
I'm wondering if anyone knows of any studies that discuss the cost effectiveness of various adherence interventions in resource-poor settings. There seem to be many from the US and other developed countries, but because prices and infrastructure are so different, they can't really be applied. Everything related to developing countries seems to be qualitative. If anyone could point me in the direction of some quantitative studies I would be so grateful!
Thanks!
Hannah Mogul-Adlin
Clinical Support Team Intern
The Clinton Foundation

Replies

 

K. Rivet Amico, PhD Replied at 4:13 AM, 30 Jun 2009

I think cost effectiveness and demonstration studies in general have received less attention than needed in this area-- thus cost effectiveness if often guess work when moving from a RCT to real world applications. This, coupled with what you have already noted in terms of a need for more research establishing adherence interventions that are effective in resource-constrained and diverse cultural settings, makes determining which interventions are both demonstrated and cost effective in a given region a real challenge.

As for quantitative studies in resource-limited settings, Pearson et al (2006) provide data on peer-delivered DOT that may be of interest as an approach to consider. At IAPAC this year, Paul Farmer presented on accompaniment programs as ultimately highly cost effective in promoting long term health and disease management. Seems like DOT is the best represented (from my perspective) but certainly there are many more options to consider. I am certain there is more out there then what I could locate (or at least I really hope there is because I could not locate much from our previous meta analytic work or an updated lit search).

Wish I could be of more help. I am looking forward to what the community has to offer in response to your post.

Sincerely,
Rivet Amico
Center for Health Intervention and Prevention
University of Connecticut

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