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Randomized Controlled Trial
. 2014 Aug;64(625):e493-9.
doi: 10.3399/bjgp14X680977.

Cost effectiveness of a web-based decision aid for parents deciding about MMR vaccination: a three-arm cluster randomised controlled trial in primary care

Sandy Tubeuf  1 , Richard Edlin  2 , Swati Shourie  3 , Francine M Cheater  4 , Hilary Bekker  1 , Cath Jackson  5
Affiliations
Randomized Controlled Trial

Cost effectiveness of a web-based decision aid for parents deciding about MMR vaccination: a three-arm cluster randomised controlled trial in primary care

Sandy Tubeuf et al. Br J Gen Pract. 2014 Aug.

Abstract

Background: Levels of measles in England and Wales are at their highest for 18 years, and strategies targeting the different groups of parents who do not vaccinate their children continue to be needed. Decision aids for decisions regarding childhood immunisation appear to be effective in achieving an increase in vaccine uptake but their cost effectiveness is unknown.

Aim: To assess the cost effectiveness of a web-based decision aid to increase uptake of the MMR vaccine.

Design and setting: Economic evaluation conducted alongside a cluster randomised controlled trial using urban GP practices in the north of England.

Method: Fifty GP practices in the north of England were randomised to one of three trial arms: decision aid, leaflet, usual practice. A total of 220 first-time parents (child aged 3-12 months) were recruited. Parents self-reported their contacts with the NHS and other previous/expected resource utilisation; associated costs were calculated. Vaccine-uptake data were collected from GP practices. A cost-effectiveness analysis was undertaken and provided the incremental cost per first-vaccine uptake. Multiple imputation was used to account for missing data and findings were adjusted for baseline differences in parents' levels of decisional conflict regarding MMR vaccination.

Results: Of the 220 first-time parents recruited to the study, 179 completed the baseline and post-intervention questionnaires. MMR uptake was highest for those receiving the decision aid (42 out of 42, 100%) versus usual practice (61 out of 62, 98%) and leaflet arm (69 out of 75, 92%), and was associated with lower cost (-£9.20 versus usual practice and -£7.17 versus leaflet).

Conclusion: The decision aid has a high chance of being cost effective, regardless of the value placed on obtaining additional vaccinations. It also appears to offer an efficient means of decision support for parents.

Keywords: MMR; cost effectiveness; decision aids; immunisation; vaccination.

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Figures

Figure 1.
Figure 1.
Cost-effectiveness acceptability curve.
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References

    1. Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351(9103):637–641. Retraction in Lancet 2010 375 (9713): 445. - PubMed
    1. Smith A, Yarwood J, Salisbury DM. Tracking mothers’ attitudes to MMR immunisation 1996–2006. Vaccine. 2007;25(3996):6. - PubMed
    1. Public Health England. Quarterly Vaccine Coverage Data Tables. Cover data Q12–4 Jan to March 2013. http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/VaccineCove... (accessed 1 Jul 2014)
    1. World Health Organization Regional office for Europe. Experts meet to discuss verification process for measles and rubella elimination. http://www.euro.who.int/en/health-topics/communicable-diseases/measles-a... (accessed 7 Jul 2014)
    1. Poland GA, Jacobson RM. The re-emergence of measles in developed countries: Time to develop the next-generation measles vaccines? Vaccine. 2012;30(2):103–104. - PMC - PubMed

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