Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care
2010 (English)In: Archives of Internal Medicine, ISSN 0003-9926, E-ISSN 1538-3679, Vol. 170, no 16, 1470-1479 p.Article in journal (Refereed) Published
Background: Lifestyle interventions reduce cardiovascular risk and diabetes but reports on long term effects on quality of life (QOL) and health care utilization are rare. The aim was to investigate the impact of a primary health care based lifestyle intervention program on QOL and cost-effectiveness over 3 years.
Methods: 151 men and women, age 18-65 yr, at moderate-to-high risk for cardiovascular disease, were randomly assigned to either lifestyle intervention with standard care or standard care alone. Intervention consisted of supervised exercise sessions and diet counseling for 3 months, followed by regular group meetings during 3years. Change in QOL was measured with EuroQol (EQ-5D, EQ VAS), the 36-item Short Form Health Survey (SF-36), and the SF-6D. The health economic evaluation was performed from a societal view and a treatment perspective. In a cost-utility analysis the costs, gained quality-adjusted life years (QALY) and savings in health care were considered. Cost-effectiveness was also described using the Net Monetary Benefit Method.
Results: Significant differences between groups over the 3-yr period were shown in EQ VAS, SF-6D and SF-36 physical component summary but not in EQ-5D or SF-36 mental component summary. There was a net saving of 47 USD per participant. Costs per gained QALY, savings not counted, were 1,668 – 4,813 USD. Probabilities of cost-effectiveness were 89 – 100 %, when 50 000 USD was used as stakeholder’s threshold of willingness to pay for a gained QALY.
Conclusion: Lifestyle intervention in primary care improves QOL and is highly cost-effective in relation to standard care.
Place, publisher, year, edition, pages
Chicago: American Medical Association , 2010. Vol. 170, no 16, 1470-1479 p.
randomized controlled trial, physical activity, body mass, women, prescription, utilities, exercise, efficacy, program, Sweden
Research subject Physiotherapy
IdentifiersURN: urn:nbn:se:umu:diva-32764DOI: 10.1001/archinternmed.2010.301ISI: 000281764100009OAI: oai:DiVA.org:umu-32764DiVA: diva2:305702