Roger Watson, Editor-in-Chief
Pressure ulcers are the problem that never goes away. From a mentality that used to say that they should always be prevented and always could be prevented, it is now clear that they are very hard to prevent but that some strategies are better than others. However, where differences in effectiveness are marginal the issue of cost-effectiveness is an essential factor to study.
A recent UK study by Marsden et al. (2015) titled 'A cost-effectiveness analysis of two different repositioning strategies for the prevention of pressure ulcers' and published in JAN uses a health economics approach to 'assess the cost effectiveness of two repositioning strategies and inform the 2014 National Institute for Health and Care Excellence clinical guideline recommendations on pressure ulcer prevention'. The data for the inputs to the model were obtained from a systematic review and the health economic methods are fully described.
The outcome of the study is best described in the authors own words: 'this analysis found that alternating 2 and 4 hourly repositioning is not cost-effective compared with 4 hourly repositioning, as a PU prevention strategy in older people in a nursing home with non-blanchable erythema. This conclusion was robust to a range of sensitivity analyses, demonstrating that despite uncertainty around the model inputs, variation within reasonable ranges does not alter the conclusion.'
You can listen to this as a podcast.
Marsden G, Jones K, Neilson J, Avital L, Collier M, Standby G (2015) A cost-effectiveness analysis of two different repositioning strategies for the prevention of pressure ulcers Journal of Advanced Nursing doi: 10.1111/jan.12753