Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial
| Autor: | Goranitis, I, Bellanca, L, Daley, A, Thomas, A, Stokes-Lampard, H, Roalfe, A, Jowett, S |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Economics
Cost-Benefit Analysis Cost-Effectiveness Analysis Social Sciences lcsh:Medicine State Medicine Health Economics Drug Therapy Complementary and Alternative Medicine Aerobic Exercise Medicine and Health Sciences Humans Public and Occupational Health Sports and Exercise Medicine lcsh:Science Exercise Health Care Rationing Pharmaceutics lcsh:R Hormonal Therapy Biology and Life Sciences Physical Activity Middle Aged Sports Science Economic Analysis United Kingdom Exercise Therapy Health Care Vasomotor System Physical Fitness Quality of Life Female lcsh:Q Menopause Research Article |
| Zdroj: | PLoS ONE, Vol 12, Iss 9, p e0184328 (2017) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | ObjectiveTo compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. DesignEconomic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. SettingPrimary care. PopulationPeri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. MethodsAn individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. Main outcome measureCost per quality-adjusted life-year (QALY). ResultsData for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. ConclusionsExercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms. |
| Databáze: | OpenAIRE |
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