or not, over-weight or not, high cholesterol or not and EQ-5D index score). A willingness to pay of £20,000 per additional QALY was chosen (NICE 2008); if the incremental net beneﬁt was greater than 0 the LAMP would be considered effective. To assess the level of uncertainty associated with the decision as to which intervention was most cost-effective, the cost-effectiveness acceptability curve (CEAC) is plotted (Van Hout et al. 2006). The CEAC shows the probability that the lay- facilitated angina management is more cost-effective than usual care, for different thresholds of willingness to pay for additional beneﬁt (QALY). Results Despite extending recruitment by 6 months, only 261 patients were eligible for the study, of whom 142 (54%) agreed to participate (70 randomized to LAMP and 72 to control). Baseline characteristics of the participants are shown in Table 1. At 6-month follow-up, data were collected from 124 (87%) of the participants, those continuing in the study were signiﬁcantly younger than those who withdrew (62Æ9 vs. 71Æ5, Table 1 Baseline characteristics. Age, Mean years (SD) Female, n (%) Marital status, n (%) Divorced Married or in partnership Single Widowed Canadian angina class, n (%) I II III Work activity, n (%) Employed Retired Other Charlson comorbidity score, Mean (SD) Smoker current, n (%) Systolic blood pressure, Mean (SD) Total cholesterol, Mean (SD) Body mass index, Mean (SD) Waist/hip ratio, Mean (SD) Angina episodes, count over 1 week, median (25–75 percentile) 2012 Blackwell Publishing Ltd JAN: ORIGINAL RESEARCH RCT of a lay-facilitated angina management programme 95% CI = 3Æ39–13Æ95) but there was no difference in gender or in number of angina episodes recorded at baseline. The primary analysis did not ﬁnd any important differences in the rate of angina between the treatment groups at month six. The rate was measured over a sample week. The incidence rate ratio for Control (n = 57) vs. LAMP (n = 58) was 0Æ96 (95% CI: 0Æ39–2Æ38; P = 0Æ926), compared to LAMP, the control group had an angina rate over the sample week of 0Æ96 times less than the LAMP group. This difference was not statistically signiﬁcant. At 6 months, the median number of angina episodes over 1 week was nil in both groups, a reduction from a median of 3 at baseline for LAMP group and 2 for control group. The proportion of patients that were angina free at 6 months was 75% for the LAMP group and 62% for the control group. Of the secondary outcomes (Table 2), there were impor- tant differences in favour of the LAMP group for: waist-to- hip ratio at 6 months, anxiety at 3 and 6 months, depression at 6 months but not at 3 months, and angina misconceptions at both time points. Signiﬁcantly more of this group also reported meeting guideline amounts of exercise at 3 months but not at 6 months. The LAMP group had signiﬁcantly higher quality of life as measured by EQ-5D index scores, at both 3 months [mean (SD) = 0Æ82 (0Æ21) vs. 0Æ70 (0Æ28) P = 0Æ01] and at 6 months [mean (SD) = 0Æ82 (0Æ24) vs. 0Æ68 (0Æ32) P = 0Æ008]. The remaining outcomes were not signif- icantly different between the two groups. Resource use and cost Cost of treatment – intervention A total of six lay facilitators were recruited in the LAMP trial and each cost £179 for training. The cost of a lay worker per hour was £6Æ15 whilst the travel costs per home visit was assumed at £5 per trip. The cost of per telephone call (for 15 minutes) and a supporting material (workbook) were £0Æ05 and £10, respectively. The fre- quency and durations of home-visits and phone calls per patient received were recorded during the follow-up period by their lay workers. Control A 20 minutes meeting with a cardiac rehabilitation nurse specialist cost £12Æ67. Table 3 presents healthcare utilization by each follow-up and group. There were no important dif- ferences between the groups for GP visits or hospitalizations at 3 or 6 months. In terms of total cost calculation (imputed and adjusted), the cost of healthcare utilization per patient 2273 LAMP (n = 70) Control (n = 72) 65Æ30 (9Æ66) 29 (41Æ43) 63Æ55 (10Æ19) 38 (52Æ78) 5 (7Æ25) 56 (81Æ16) 2 (2Æ90) 6 (8Æ70) 16 (22Æ86) 42 (60Æ00) 12 (17Æ14) 21 (30Æ9) 36 (52Æ9) 11 (16Æ2) 0Æ37 (0Æ68) 8 (11Æ11) 53 (73Æ61) 1 (1Æ39) 10 (13Æ89) 11 (15Æ28) 44 (61Æ11) 17 (23Æ61) 17 (25Æ8) 41 (62Æ1) 8 (12Æ1) 0Æ35 (0Æ59) 16 (22Æ86) 141Æ90 (19Æ01) 6 (8Æ33) 142Æ71 (16Æ48) 4Æ65 (1Æ11) 28Æ73 (6Æ34) 0Æ98 (0Æ13) 3 (0–5) 5Æ33 (1Æ24) 27Æ97 (4Æ64) 0Æ95 (0Æ10) 2 (0–8)