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Watchful waiting urged for recurrent upper respiratory tract infections
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Watchful waiting may be more cost-effective than immediate adenoidectomy for patients who have recurrent upper respiratory tract infections, according to the results of a study from the Netherlands.
Chantal W.B. Boonacker, PhD, of the Julius Center for Health Sciences and Primary Care, and colleagues conducted a cost-minimization analysis, along with an open randomized controlled trial with a 2-year follow-up. They analyzed direct and indirect costs associated with adenoidectomy in 111 children, aged 1 to 6 years, using data from 13 hospitals.
The researchers reported that the “median total of direct and indirect costs in the adenoidectomy and watchful waiting group were about $2,000 and about $1,216 per patient, respectively.” The researchers attributed the price difference to the costs of the surgery and visits to a specialist.
The study researchers said the strength of their study is that costs were measured prospectively alongside the randomized trial that used societal perspective and all relevant costs.
The findings of this study concur with three previous studies that reported higher costs for adenotonsillectomy in children with mild to moderate throat infections and tympanostomy tubes in children with otitis media with effusion.
The researchers noted some study limitations; specifically, that some of the children who were initially under a watchful waiting approach had to have surgery during the study, and the results may not be generalizable to other countries.
Disclosure: The study was funded by a grant from ZonMw – The Netherlands Organization for Health Research and Development, Health Care Efficiency Research Program. Some researchers reported receiving honoraria from GlaxoSmithKline for participation in expert meetings and other workshops.
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