Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management
| Autor: | Gerhard A. Zielhuis, Paul van der Valk, Jacobus Adrianus Maria van der Palen, Huib A. M. Kerstjens, Marjolein Brusse-Keizer, T. W. Effing, Marlies Zwerink |
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| Přispěvatelé: | Faculty of Behavioural, Management and Social Sciences, Groningen Research Institute for Asthma and COPD (GRIAC) |
| Rok vydání: | 2016 |
| Předmět: |
Male
METIS-313783 self-management Time Factors Cost effectiveness Cost-Benefit Analysis medicine.medical_treatment POPULATION-BASED COHORT physical activity Pulmonary Disease Chronic Obstructive 0302 clinical medicine Surveys and Questionnaires 030212 general & internal medicine health care economics and organizations Community based COPD Rehabilitation Self-management exercise Middle Aged Exercise capacity Exercise Therapy IR-98647 Female Quality-Adjusted Life Years Pulmonary and Respiratory Medicine REHABILITATION medicine.medical_specialty Physical activity OBSTRUCTIVE PULMONARY-DISEASE Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] 03 medical and health sciences medicine Humans community-based cost-effectiveness Retrospective Studies business.industry MORTALITY SHUTTLE WALKING TEST medicine.disease EUROQOL Exercise programme Self Care PHYSICAL-ACTIVITY 030228 respiratory system Quality of Life Physical therapy business FOLLOW-UP Follow-Up Studies |
| Zdroj: | Copd-Journal of Chronic Obstructive Pulmonary Disease, 13, 214-23 COPD : Journal of Chronic Obstructive Pulmonary Disease, 13, 2, pp. 214-23 COPD, 13(2), 214-223. Informa Healthcare COPD: Journal of Chronic Obstructive Pulmonary Disease, 13(2), 214-223. Taylor & Francis Group |
| ISSN: | 1541-2555 |
| Popis: | Item does not contain fulltext INTRODUCTION: Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. METHODS: All included COPD patients participated in four self-management sessions. Additionally, patients in the COPE-active group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained 3 times/week for 6 months and two times/week during the subsequent 5 months. In both periods, one of these weekly training sessions was home-based (unsupervised). No formal physiotherapy sessions were offered to COPE-active patients in the second year. A decision analytical model with a 24-month perspective was used to evaluate cost-effectiveness. Incremental cost-effectiveness ratios (ICER) were calculated and cost-effectiveness planes were created. RESULTS: Data of 77 patients participating in the exercise programme and 76 patients in the control group were analysed. The ICER for an additional patient prevented from deteriorating at least 47.5 meters on the ISWT was euro6257. The ICER for an additional patient with a clinically relevant improvement (>/= 500 steps/day) in physical activity was euro1564, and the ICER for an additional quality-adjusted life year (QALY) was euro10 950. CONCLUSION: Due to a lack of maintenance of beneficial effects on our primary outcome exercise capacity after 2 years of follow-up and higher costs of the programme, the community-based exercise programme cannot be considered cost-effective compared to self-management programmes only. Nevertheless, the ICERs for the secondary outcomes physical activity and QALY are generally considered acceptable. |
| Databáze: | OpenAIRE |
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