The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: Findings from the EpAID study

Mark Pennington, Howard Ring, James Howlett, Christopher Smith, Marcus Redley, Caroline Murphy, Roxanne Hook, Adam Platt, Nakita Gilbert, Elizabeth Jones, Joanna Kelly, Angela Pullen, Adrian P. Mander, Cam Donaldson, Simon Rowe, James Wason, Fiona Irvine

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Background: The development of a nurse-led approach to managing epilepsy in adults with an intellectual disability offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of intellectual disability nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs.
Method: Across the UK, 8 sites randomly allocated to the intervention recruited 184 participants, 9 sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after six months. Total costs at six months were compared from the perspective of health & social services, and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data was imputed using Multiple Imputation. Uncertainty was quantified by bootstrapping.
Results: The intervention was associated with lower per participant costs from a health & social services perspective of -£357 (2014/15 GBP) (95% CI -£986, £294) and from a societal perspective of -£631 (95% CI -£1,473, £181). Results were not sensitive to the exclusion of accommodation costs.
Conclusions: Our findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and intellectual disability and may reduce costs.
Original languageEnglish
Pages (from-to)1391-1400
Number of pages10
JournalJournal of Intellectual Disability Research
Issue number12
Early online date8 Aug 2019
Publication statusPublished - Dec 2019

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