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Cost-utility of a cardiovascular prevention program in highly educated adults: Intermediate results of a randomized controlled trial

Published online by Cambridge University Press:  08 January 2010

Nele Jacobs ,
Silvia Evers ,
Andre Ament  and
Neree Claes
Nele Jacobs
Affiliation:
Hasselt University
Silvia Evers
Affiliation:
Maastricht University
Andre Ament
Affiliation:
Maastricht University
Neree Claes
Affiliation:
Hasselt University
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Abstract

Objectives: Little is known about the costs and the effects of cardiovascular prevention programs targeted at medical and behavioral risk factors. The aim was to evaluate the cost-utility of a cardiovascular prevention program in a general sample of highly educated adults after 1 year of intervention.

Methods: The participants were randomly assigned to intervention (n = 208) and usual care conditions (n = 106). The intervention consisted of medical interventions and optional behavior-change interventions (e.g., a tailored Web site). Cost data were registered from a healthcare perspective, and questionnaires were used to determine effectiveness (e.g., quality-adjusted life-years [QALYs]). A cost-utility analysis and sensitivity analyses using bootstrapping were performed on the intermediate results.

Results: When adjusting for baseline utility differences, the incremental cost was €433 and the incremental effectiveness was 0.016 QALYs. The incremental cost-effectiveness ratio was €26,910 per QALY.

Conclusions: The intervention was cost-effective compared with usual care in this sample of highly educated adults after 1 year of intervention. Increased participation would make this intervention highly cost-effective.

Keywords

Cost-utilityCost-effectivenessCardiovascular preventionBehavior
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 1 , January 2010 , pp. 11 - 19
Copyright
Copyright © Cambridge University Press 2010

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References

REFERENCES

1. Aaronson, NK, Muller, M, Cohen, PD, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1055–1068.CrossRefGoogle ScholarPubMed
2. Ajzen, I. Theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRefGoogle Scholar
3. Annemans, L, Lamotte, M, Clarys, P, Van Den Abeele, E. Health economic evaluation of controlled and maintained physical exercise in the prevention of cardiovascular and other prosperity diseases. Eur J Cardiovasc Prev Rehabil. 2007;14:815–824.CrossRefGoogle ScholarPubMed
4. Bemelmans, W, van Baal, P, Wendel-Vos, W, et al. The costs, effects and cost-effectiveness of counteracting overweight on a population level. A scientific base for policy targets for the Dutch national plan for action. Prev Med. 2008;46:127–132.CrossRefGoogle Scholar
5. Brazier, J, Roberts, J, Deverill, M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002;21:271–292.CrossRefGoogle ScholarPubMed
6. Claes, N, Jacobs, N. The PreCardio-study protocol—a randomized clinical trial of a multidisciplinary electronic cardiovascular prevention programme. BMC Cardiovasc Disord. 2007;7:27.CrossRefGoogle ScholarPubMed
7. Claes, N, Moeremans, K, Frank, B, et al. Estimating the cost-effectiveness of quality-improving interventions in oral anticoagulation management within general practice. Value Health. 2006;9:369–376.CrossRefGoogle ScholarPubMed
8. De Backer, G, Ambrosioni, E, Borch-Johnsen, K, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2003;24:1601–1610.CrossRefGoogle ScholarPubMed
9. De Bacquer, D, De Backer, G. The prevalence of concomitant hypertension and hypercholesterolaemia in the general population. Int J Cardiol. 2006;110:217–223.CrossRefGoogle ScholarPubMed
10. Gordon, L, Graves, N, Hawkes, A, Eakin, E. A review of the cost-effectiveness of face-to-face behavioural interventions for smoking, physical activity, diet and alcohol. Chronic Illn. 2007;3:101–129.CrossRefGoogle ScholarPubMed
11. Graves, N, McKinnon, L, Reeves, M, et al. Cost-effectiveness analyses and modelling the lifetime costs and benefits of health-behaviour interventions. Chronic Illn. 2006;2:97–107.CrossRefGoogle ScholarPubMed
12. Grover, SA, Coupal, L, Lowensteyn, I. Determining the cost-effectiveness of preventing cardiovascular disease: Are estimates calculated over the duration of a clinical trial adequate? Can J Cardiol. 2008;24:261–266.CrossRefGoogle ScholarPubMed
13. Gusi, N, Reyes, MC, Gonzalez-Guerrero, JL, et al. Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: A randomised controlled trial. BMC Public Health. 2008;8:231.CrossRefGoogle ScholarPubMed
14. Jacobs, N, Claes, N. An autonomy-supporting cardiovascular prevention programme: Practical recommendations from self-determination theory. Eur Health Psychol. 2008;10:74–76.Google Scholar
15. Kroeze, W, Werkman, A, Brug, J. A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Ann Behav Med. 2006;31:205–23.CrossRefGoogle ScholarPubMed
16. Leal, J, Luengo-Fernandez, R, Gray, A, et al. Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J. 2006;27:1610–1619.CrossRefGoogle ScholarPubMed
17. Manca, A, Hawkins, N, Sculpher, MJ. Estimating mean QALYs in trial-based cost-effectiveness analysis: The importance of controlling for baseline utility. Health Econ. 2005;14:487–496.CrossRefGoogle ScholarPubMed
18. Munro, JF, Nicholl, JP, Brazier, JE, et al. Cost effectiveness of a community based exercise programme in over 65 year olds: Cluster randomised trial. J Epidemiol Community Health. 2004;58:1004–1010.CrossRefGoogle ScholarPubMed
19. National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal. Draft for consultation. London: NICE; 2007.Google Scholar
20. Ronckers, ET, Groot, W, Steenbakkers, M, et al. Costs of the ‘Hartslag Limburg’ community heart health intervention. BMC Public Health. 2006;6:51.CrossRefGoogle ScholarPubMed
21. RVZ. Zinnige en duurzame zorg. Zoetermeer: Raad voor de Volksgezondheid en Zorg; 2006.Google Scholar
22. Ryan, RM, Deci, EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78.CrossRefGoogle ScholarPubMed
23. van Keulen, HM, Mesters, I, Brug, J, et al. Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors. BMC Public Health. 2008;8:216.CrossRefGoogle ScholarPubMed
24. Vandelanotte, C, De Bourdeaudhuij, I, Sallis, JF, et al. Efficacy of sequential or simultaneous interactive computer-tailored interventions for increasing physical activity and decreasing fat intake. Ann Behav Med. 2005;29:138–146.CrossRefGoogle ScholarPubMed
25. Vandelanotte, C, De Bourdeaudhuij, I, Philippaerts, R, Sjöström, M, Sallis, M. Reliability and validity of a computerized and Dutch version of the international physical activity questionnaire (IPAQ). J Phys Act Health. 2005;2:63–75.CrossRefGoogle Scholar
26. Vandelanotte, C, Matthys, C, De Bourdeaudhuij, I. Reliability and validity of a computerised questionnaire to measure fat intake in Belgium. Nutr Res. 2004;24:621–631.CrossRefGoogle Scholar
27. Walters, SJ, Brazier, JE. Sample sizes for the SF-6D preference based measure of health from the SF-36: A comparison of two methods. Health Serv Outcomes Res Methodol. 2003;4:35–47.CrossRefGoogle Scholar
28. WHO. The global burden of disease: 2004 update. Geneva: World Health Organization; 2008.Google Scholar
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