The health technology assessment (HTA) was requested by the Health Service Executive (HSE) to inform the development of a chronic disease self management support framework for the Irish health service. The assessment was carried out by an Evaluation Team from the HTA Directorate in HIQA. A multidisciplinary Expert Advisory Group was established to provide advice on the assessment.
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HTA of Chronic Disease Self-Management
Foreword
To inform the development of a chronic disease self management support framework for the Irish health service.
In December 2014, the Health Information and Quality Authority (HIQA) received a request from the Health Service Executive (HSE) to examine the clinical and cost-effectiveness of generic self-management support (SMS) interventions for chronic diseases and disease-specific interventions for chronic obstructive pulmonary disease (COPD), asthma, cardiovascular disease and diabetes.
This health technology assessment (HTA) of self-management support (SMS) interventions was undertaken as a series of rapid HTAs. As per the terms of reference, individual disease-specific assessments were prepared for asthma, chronic obstructive pulmonary disease, diabetes, cardiovasculuar disease (hypertension, stroke, ischaemic heart disease, and heart failure) as well as an assessment of generic SMS interventions not tailored to any one specific disease. The term ‘rapid HTA’ is analogous to that of a ‘mini-HTA’; both terms are widely used in the international HTA setting to refer to a HTA with restricted research questions whose purpose is to inform decision making in a particular service setting or for a specific group of patients. Based on the approach used in a full HTA assessment, a rapid HTA uses a truncated research strategy with the review of published literature often restricted to a review of the secondary literature (including systematic reviews, meta-analysis, guidelines etc.) and does not include development of an independent economic model. This approach is useful when undertaking assessments that are proportionate to the needs of the decision maker.
A systematic review of chronic disease self-management support (SMS) interventions was undertaken for generic interventions and disease-specific interventions for each of the identified chronic diseases to identify, appraise and synthesise the best available evidence on their clinical effectiveness and safety.
This review included:
- development of a systematic review protocol
- appraisal and synthesis of all available evidence in line with international best practice in systematic reviews of interventions.