Economic Evaluation of MEW Network Epilepsy Self-Management Programs

New York University School Of Medicine, New York NY

Investigators

Abstract

ABSTRACT: The Managing Epilepsy Well (MEW) Network has developed several epilepsy self-management programs that have been shown to improve a range of health outcomes for people with epilepsy (PWE). Two of these programs are UPLIFT (Using Practice and Learning to Increase Favorable Thoughts), which focuses on depressive symptoms, and PACES (Program of Active Consumer Engagement in Self-Management in Epilepsy), which targets epilepsy self-management more broadly. In prior and current funding cycles, the NYU MEW Network Collaborating Center adapted UPLIFT for Hispanic PWE, evaluated the adapted program, and is currently conducting a replication trial in a diverse sample of PWE. UPLIFT and PACES are prime candidates for widespread dissemination given their efficacy, scalability, availability in English and Spanish, and implementation structure (e.g., national facilitator training and technical assistance programs). Implementation of UPLIFT and PACES in healthcare and community settings is ongoing but remains limited by the lack of discrete, sustainable funding models. To facilitate program adoption and maintenance, key questions related to costs and cost-effectiveness of the programs must be addressed. We propose to conduct economic evaluations of UPLIFT and PACES that will generate critical data to enhance adoption in clinical and community settings, and help identify strategies for reimbursement. We will analyze data from completed and ongoing RCTs testing these programs; collect surveys from the large national pool of trained UPLIFT and PACES implementers; and conduct prospective studies of UPLIFT and PACES in both healthcare and community-based settings in New York. PWE will be enrolled from epilepsy clinics at NYU Langone (Manhattan and Brooklyn) and from the Epilepsy Alliance of West Central New York. Guided by Gold et al.’s (2022) model of measuring cost data in implementation science, we will assess implementation, intervention, and downstream costs for the proposed economic evaluations. We will form an Advisory Board comprised of clinicians, administrators, community partners, implementation scientists, and program facilitators to ensure that all data needed to inform future decision making are collected. Our specific aims are to (1) Implement UPLIFT and PACES in healthcare and community-based settings; (2) Measure implementation, intervention and downstream costs of the two programs; (3) Conduct economic evaluations of UPLIFT and PACES; and (4) Continue and expand collaborations with other MEW Network centers. Our multi-pronged approach will allow us to evaluate the costs of implementing UPLIFT and PACES in both clinical and community settings, with diverse patients (including Spanish speakers), and with different facilitator types in order to better understand costs associated with these variations. By generating data on costs and cost-effectiveness of UPLIFT and PACES, we will provide critical evidence to inform strategies to enhance their adoption and sustainability, ultimately leading to improved health and quality of life among diverse PWE.