Economic evaluation of a web-based tailored lifestyle intervention for adults: findings regarding cost-effectiveness and cost-utility from a randomized controlled trial

Autor: H. de Vries, Eline Suzanne Smit, N.E. Stanczyk, Silvia M. A. A. Evers, Stef P. J. Kremers, Dirk Schulz
Přispěvatelé: Persuasive Communication (ASCoR, FMG), Health promotion, Health Services Research, RS: CAPHRI School for Public Health and Primary Care, RS: NUTRIM - R1 - Metabolic Syndrome, RS: CAPHRI - Health Technology Assessment, RS: CAPHRI - Health Promotion and Health Communication
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Male
Gerontology
economic evaluation
INFORMATION
Cost effectiveness
Cost-Benefit Analysis
Health Behavior
Psychological intervention
COMMUNICATION
law.invention
Randomized controlled trial
law
QUALITY-OF-LIFE
Surveys and Questionnaires
Health care
PROGRAM
Medicine
lcsh:Public aspects of medicine
Smoking
Health Care Costs
Middle Aged
OBESITY
Absenteeism
lcsh:R858-859.7
Female
Quality-Adjusted Life Years
HEALTH
computer-tailoring
lifestyle behaviors
Adult
Alcohol Drinking
Health Informatics
Health Promotion
BEHAVIORS
lcsh:Computer applications to medicine. Medical informatics
Quality of life (healthcare)
Willingness to pay
Humans
cost-utility
Exercise
Life Style
cost-effectiveness
Original Paper
Internet
business.industry
lcsh:RA1-1270
FRAMEWORK
PREVENTION
Diet
PHYSICAL-ACTIVITY
Internet interventions
Economic evaluation
randomized controlled trial
Quality of Life
Web-based
business
Zdroj: Journal of Medical Internet Research, 16(3):e91. Journal of medical Internet Research
Journal of Medical Internet Research, 16(3):e91, 383-400. JMIR Publications Inc.
Journal of Medical Internet Research, Vol 16, Iss 3, p e91 (2014)
Journal of Medical Internet Research
ISSN: 1438-8871
Popis: BackgroundDifferent studies have reported the effectiveness of Web-based computer-tailored lifestyle interventions, but economic evaluations of these interventions are scarce. ObjectiveThe objective was to assess the cost-effectiveness and cost-utility of a sequential and a simultaneous Web-based computer-tailored lifestyle intervention for adults compared to a control group. MethodsThe economic evaluation, conducted from a societal perspective, was part of a 2-year randomized controlled trial including 3 study groups. All groups received personalized health risk appraisals based on the guidelines for physical activity, fruit intake, vegetable intake, alcohol consumption, and smoking. Additionally, respondents in the sequential condition received personal advice about one lifestyle behavior in the first year and a second behavior in the second year; respondents in the simultaneous condition received personal advice about all unhealthy behaviors in both years. During a period of 24 months, health care use, medication use, absenteeism from work, and quality of life (EQ-5D-3L) were assessed every 3 months using Web-based questionnaires. Demographics were assessed at baseline, and lifestyle behaviors were assessed at both baseline and after 24 months. Cost-effectiveness and cost-utility analyses were performed based on the outcome measures lifestyle factor (the number of guidelines respondents adhered to) and quality of life, respectively. We accounted for uncertainty by using bootstrapping techniques and sensitivity analyses. ResultsA total of 1733 respondents were included in the analyses. From a willingness to pay of €4594 per additional guideline met, the sequential intervention (n=552) was likely to be the most cost-effective, whereas from a willingness to pay of €10,850, the simultaneous intervention (n=517) was likely to be most cost-effective. The control condition (n=664) appeared to be preferred with regard to quality of life. ConclusionsBoth the sequential and the simultaneous lifestyle interventions were likely to be cost-effective when it concerned the lifestyle factor, whereas the control condition was when it concerned quality of life. However, there is no accepted cutoff point for the willingness to pay per gain in lifestyle behaviors, making it impossible to draw firm conclusions. Further economic evaluations of lifestyle interventions are needed. Trial RegistrationDutch Trial Register NTR2168; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2168 (Archived by WebCite at http://www.webcitation.org/6MbUqttYB).
Databáze: OpenAIRE
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