Cost-effectiveness of a telephone-delivered intervention for physical activity and diet
| Autor: | Kate Halton, Elizabeth G. Eakin, Neville Owen, Nicholas Graves, Alison L. Marshall, Elisabeth A. H. Winkler, Adrian G. Barnett, Marina M. Reeves, JL Veerman |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Cost effectiveness Cost-Benefit Analysis Psychological intervention lcsh:Medicine law.invention 0302 clinical medicine Evidence-Based Healthcare/Health Services Research and Economics Randomized controlled trial law Nutrition/Obesity 11. Sustainability Health care Outcome Assessment Health Care 030212 general & internal medicine lcsh:Science Multidisciplinary 030503 health policy & services Evidence-Based Healthcare/Clinical Decision-Making Cost-effectiveness analysis Middle Aged Telemedicine 3. Good health Hypertension Female Public Health and Epidemiology/Exercise and Sports 0305 other medical science Research Article medicine.medical_specialty Motor Activity 03 medical and health sciences Nursing medicine Humans Diabetes and Endocrinology/Type 2 Diabetes Life Style Aged Health economics business.industry lcsh:R Australia Models Theoretical Quality-adjusted life year Diet Telephone Diabetes Mellitus Type 2 Social Class Family medicine lcsh:Q Brief intervention business Public Health and Epidemiology/Social and Behavioral Determinants of Health |
| Zdroj: | PLoS ONE PLoS ONE, Vol 4, Iss 9, p e7135 (2009) |
| ISSN: | 1932-6203 |
| Popis: | BACKGROUND: Given escalating rates of chronic disease, broad-reach and cost-effective interventions to increase physical activity and improve dietary intake are needed. The cost-effectiveness of a Telephone Counselling intervention to improve physical activity and diet, targeting adults with established chronic diseases in a low socio-economic area of a major Australian city was examined. METHODOLOGY/PRINCIPAL FINDINGS: A cost-effectiveness modelling study using data collected between February 2005 and November 2007 from a cluster-randomised trial that compared Telephone Counselling with a "Usual Care" (brief intervention) alternative. Economic outcomes were assessed using a state-transition Markov model, which predicted the progress of participants through five health states relating to physical activity and dietary improvement, for ten years after recruitment. The costs and health benefits of Telephone Counselling, Usual Care and an existing practice (Real Control) group were compared. Telephone Counselling compared to Usual Care was not cost-effective ($78,489 per quality adjusted life year gained). However, the Usual Care group did not represent existing practice and is not a useful comparator for decision making. Comparing Telephone Counselling outcomes to existing practice (Real Control), the intervention was found to be cost-effective ($29,375 per quality adjusted life year gained). Usual Care (brief intervention) compared to existing practice (Real Control) was also cost-effective ($12,153 per quality adjusted life year gained). CONCLUSIONS/SIGNIFICANCE: This modelling study shows that a decision to adopt a Telephone Counselling program over existing practice (Real Control) is likely to be cost-effective. Choosing the 'Usual Care' brief intervention over existing practice (Real Control) shows a lower cost per quality adjusted life year, but the lack of supporting evidence for efficacy or sustainability is an important consideration for decision makers. The economics of behavioural approaches to improving health must be made explicit if decision makers are to be convinced that allocating resources toward such programs is worthwhile. TRIAL REGISTRATION: This paper uses data collected in a previous clinical trial registered at the Australian Clinical Trials Registry, Australian New Zealand Clinical Trials Registry: Anzcrt.org.au ACTRN012607000195459. |
| Databáze: | OpenAIRE |
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