Hostname: page-component-7479d7b7d-q6k6v Total loading time: 0 Render date: 2024-07-12T11:58:56.209Z Has data issue: false hasContentIssue false
  • English
  • Français

COST-EFFECTIVENESS OF INTERVENTIONS BASED ON PHYSICAL ACTIVITY IN THE TREATMENT OF CHRONIC CONDITIONS: A SYSTEMATIC LITERATURE REVIEW

Published online by Cambridge University Press:  09 October 2018

Marlène Guillon ,
Lise Rochaix  and
Jean-Claude K. Dupont
Marlène Guillon
Affiliation:
Université Clermont Auvergne, CNRS, CERDI and Hospinnomics – PSE – École d’économie de Paris, Assistance publique Hôpitaux de Parismarlene.guillon@uca.fr
Lise Rochaix
Affiliation:
Université Paris 1 and Hospinnomics - PSE - École d’économie de Paris, Assistance publique Hôpitaux de Paris
Jean-Claude K. Dupont
Affiliation:
Hospinnomics - PSE - École d’économie de Paris, Assistance publique Hôpitaux de Paris
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The aim of this study is to review evidence on the cost-effectiveness of exercise-based interventions in the treatment of chronic conditions a decade after the publication of Roine et al. in 2009 (Roine E, Roine RP, Räsänen P, et al. Int J Technol Assess Health Care. 2009;25:427–454).

Methods:

We carried out a review of published articles in PUBMED and JSTOR between January 1, 2008, and December 31, 2016. Full economic evaluations of exercise programs targeting patients with a chronic condition were eligible for inclusion. Data on program, design, and economic characteristics were extracted using a predefined extraction form. The quality of the economic evaluations was appraised using the adjusted Consensus Health Economic Criteria List.

Results:

A total of 426 articles were identified and thirty-seven studies were selected. Eleven studies dealt with musculoskeletal and rheumatologic disorders, ten with cardiovascular diseases, six with neurological disorders, three with mental illnesses, three with cancers, and four with diabetes, respiratory diseases, or pelvic organ prolapse. In total, 60 percent of exercise programs were dominant or cost-effective. For musculoskeletal and rheumatologic disorders, 72 percent of programs were dominant or cost-effective while this was the case for 57 percent of programs for cardiovascular diseases using a nonsurgical comparator.

Conclusions:

There is clear evidence in favor of exercise-based programs for the treatment of musculoskeletal and rheumatologic disorders and, to a lesser extent, for the treatment of cardiovascular diseases. More research is needed to evaluate the cost-effectiveness of physical activity in the treatment of neurological disorders, mental illnesses, cancers, respiratory diseases, and diabetes/obesity.

Keywords

ExerciseCost-benefit analysisChronic diseaseReview
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 5 , 2018 , pp. 481 - 497
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Pedersen, BK, Saltin, B. Exercise as medicine–evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25:1-72.Google Scholar
2.Roine, E, Roine, RP, Räsänen, P, et al. Cost-effectiveness of interventions based on physical exercise in the treatment of various diseases: a systematic literature review. Int J Technol Assess Health Care. 2009;25:427-454.Google Scholar
3.OECD [Intenet]. Purchasing power parities (PPP) (indicator). [cited May 19, 2018]. https://data.oecd.org/conversion/purchasing-power-parities-ppp.htm (accessed August 14, 2018).Google Scholar
4.Higgins, JP, Altman, DG, Gøtzsche, PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.Google Scholar
5.Evers, S, Goossens, M, De Vet, H, Van Tulder, M, Ament, A. Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria. Int J Technol Assess Health Care. 2005;21:240-245.Google Scholar
6.Higgins, JP, Green, S, editors. Cochrane handbook for systematic reviews of interventions. Vol. 4. New York: John Wiley & Sons; 2011.Google Scholar
7.Odnoletkova, I, Goderis, G, Pil, L, et al. Cost-effectiveness of therapeutic education to prevent the development and progression of type 2 diabetes. Systematic Review. J Diabetes Metab. 2014;5:438.Google Scholar
8.van Eeden, M, van Heugten, CM, van Mastrigt, GA, Evers, SM. Economic evaluation studies of self-management interventions in chronic diseases: A systematic review. Int J Technol Assess Health Care. 2016;32:16-28.Google Scholar
9.Aboagye, E, Karlsson, ML, Hagberg, J, Jensen, I. Cost-effectiveness of early interventions for non-specific low back pain: A randomized controlled study investigating medical yoga, exercise therapy and self-care advice. J Rehabil Med. 2015;47:167-173.Google Scholar
10.Barton, GR, Sach, TH, Jenkinson, C, et al. Lifestyle interventions for knee pain in overweight and obese adults aged ≥ 45: Economic evaluation of randomised controlled trial. BMJ. 2009;339:b2273.Google Scholar
11.Gusi, N, Tomas-Carus, P. Cost-utility of an 8-month aquatic training for women with fibromyalgia: A randomized controlled trial. Arthritis Res Ther. 2008;10:R24.Google Scholar
12.Henchoz, Y, Pinget, C, Wasserfallen, JB, et al. Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain. J Rehabil Med. 2010;42:846-852.Google Scholar
13.Hurley, MV, Walsh, NE, Mitchell, HL, et al. Economic evaluation of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain. Arthritis Rheum. 2007;57:1220-1229.Google Scholar
14.Manning, VL, Kaambwa, B, Ratcliffe, J, et al. Economic evaluation of a brief education, self-management and upper limb exercise training in people with rheumatoid arthritis (EXTRA) programme: A trial-based analysis. Rheumatology. 2014;54:302-309.Google Scholar
15.Pinto, D, Robertson, MC, Abbott, JH, et al. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee. 2: Economic evaluation alongside a randomized controlled trial. Osteoarthritis Cartilage. 2013;21:1504-1513.Google Scholar
16.Sevick, MA, Miller, GD, Loeser, RF, Williamson, JD, Messier, SP. Cost-effectiveness of exercise and diet in overweight and obese adults with knee osteoarthritis. Med Sci Sports Exerc. 2009;41:1167-1174.Google Scholar
17.Tan, SS, van Linschoten, RL, van Middelkoop, M, et al. Cost-utility of exercise therapy in adolescents and young adults suffering from the patellofemoral pain syndrome. Scand J Med Sci Sports. 2010;20:568-579.Google Scholar
18.Tan, SS, Teirlinck, CH, Dekker, J, et al. Cost-utility of exercise therapy in patients with hip osteoarthritis in primary care. Osteoarthritis Cartilage. 2016;24:581-588.Google Scholar
19.Williams, MA, Williamson, EM, Heine, PJ, et al. Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH). A randomised controlled trial and economic evaluation. Health Technol Assess. 2015;19:1-222.Google Scholar
20.Hautala, AJ, Kiviniemi, AM, Mäkikallio, T, et al. Economic evaluation of exercise-based cardiac rehabilitation in patients with a recent acute coronary syndrome. Scand J Med Sci Sports. 2017;27:1395-1403.Google Scholar
21.Kühr, EM, Ribeiro, RA, Rohde, LEP, Polanczyk, CA. Cost-effectiveness of supervised exercise therapy in heart failure patients. Value Health. 2011;14:S100-S107.Google Scholar
22.Mazari, FAK, Khan, JA, Carradice, D, et al. Economic analysis of a randomized trial of percutaneous angioplasty, supervised exercise or combined treatment for intermittent claudication due to femoropopliteal arterial disease. Br J Surg. 2013;100:1172-1179.Google Scholar
23.Reed, SD, Whellan, DJ, Li, Y, et al. Economic evaluation of the HF-ACTION randomized controlled trial: An exercise training study of patients with chronic heart failure. Circ Cardiovasc Qual Outcomes. 2010;3:374.Google Scholar
24.Reynolds, MR, Apruzzese, P, Galper, BZ, et al. Cost-effectiveness of supervised exercise, stenting, and optimal medical care for claudication: Results from the Claudication: Exercise Versus Endoluminal Revascularization (CLEVER) trial. J Am Heart Assoc. 2014;3:e001233.Google Scholar
25.Rincón, M, Rojas, MX, Romero, VAR, et al. Economic evaluation of exercise-based cardiac rehabilitation programs for chronic heart failure patients in Colombia. J Cardiopulm Rehabil Prev. 2016;36:12-19.Google Scholar
26.Spronk, S, Bosch, JL, den Hoed, PT, et al. Cost-effectiveness of endovascular revascularization compared to supervised hospital-based exercise training in patients with intermittent claudication: A randomized controlled trial. J Vasc Surg. 2008;48:1472-1480.Google Scholar
27.van Asselt, ADI, Nicolaï, SPA, Joore, MA, Prins, MH, Teijink, JAW. Exercise Therapy in Peripheral Arterial Disease Study Group. Cost-effectiveness of exercise therapy in patients with intermittent claudication: Supervised exercise therapy versus a “go home and walk” advice. Eur J Vasc Endovasc Surg. 2011;41:97-103.Google Scholar
28.Van Den Houten, MML, Lauret, GJ, Fakhry, F, et al. Cost-effectiveness of supervised exercise therapy compared with endovascular revascularization for intermittent claudication. Br J Surg. 2016;103:1616-1625.Google Scholar
29.Witham, MD, Fulton, RL, Greig, CA, et al. Efficacy and cost of an exercise program for functionally impaired older patients with heart failure: A randomized controlled trial. Circ Heart Fail. 2012;5:209-216.Google Scholar
30.Farag, I, Sherrington, C, Hayes, A, et al. Economic evaluation of a falls prevention exercise program among people With Parkinson's disease. Mov Disord. 2016;31:53-61.Google Scholar
31.Fletcher, E, Goodwin, VA, Richards, SH, Campbell, JL, Taylor, RS. An exercise intervention to prevent falls in Parkinson's: An economic evaluation. BMC Health Serv Res. 2012;12:426.Google Scholar
32.McCrone, P, Sharpe, M, Chalder, T, et al. Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: A cost-effectiveness analysis. PLoS One. 2012;7:e40808.Google Scholar
33.Sabes-Figuera, R, McCrone, P, Hurley, M, et al. Cost-effectiveness of counselling, graded-exercise and usual care for chronic fatigue: Evidence from a randomised trial in primary care. BMC Health Serv Res. 2012;12:264.Google Scholar
34.Slaman, J, van den Berg-Emons, R, Tan, SS, et al. Cost-utility of a lifestyle intervention in adolescents and young adults with spastic cerebral palsy. J Rehabil Med. 2015;47:338-345.Google Scholar
35.Tosh, J, Dixon, S, Carter, A, et al. Cost effectiveness of a pragmatic exercise intervention (EXIMS) for people with multiple sclerosis: Economic evaluation of a randomised controlled trial. Mult Scler J. 2014;20:1123-1130.Google Scholar
36.d'Amico, F, Rehill, A, Knapp, M, et al. Cost-effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM-E randomised controlled trial. Int J Geriatr Psychiatry. 2016;31:656-665.Google Scholar
37.Edwards, RT, Linck, P, Hounsome, N, et al. Cost-effectiveness of a national exercise referral programme for primary care patients in Wales: Results of a randomised controlled trial. BMC Public Health. 2013;13:1021.Google Scholar
38.Gusi, N, Reyes, MC, Gonzalez-Guerrero, JL, Herrera, E, Garcia, JM. 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.Google Scholar
39.Gordon, LG, DiSipio, T, Battistutta, D, et al. Cost-effectiveness of a pragmatic exercise intervention for women with breast cancer: Results from a randomized controlled trial. Psychooncology. 2017;26:649-655.Google Scholar
40.Mewes, JC, Steuten, LMG, Duijts, SFA, et al. Cost-effectiveness of cognitive behavioral therapy and physical exercise for alleviating treatment-induced menopausal symptoms in breast cancer patients. J Cancer Surviv. 2015;9:126-135.Google Scholar
41.Retèl, VP, van der Molen, L, Hilgers, FJ, et al. A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy. BMC Cancer. 2011;11:475.Google Scholar
42.Panman, CM, Wiegersma, M, Kollen, BJ, et al. Two-year effects and cost-effectiveness of pelvic floor muscle training in mild pelvic organ prolapse: A randomised controlled trial in primary care. BJOG. 2017;124:511-520.Google Scholar
43.Panman, CM, Wiegersma, M, Kollen, BJ, et al. Effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training in older women with pelvic organ prolapse: 2-year follow-up of a randomized controlled trial in primary care. Menopause. 2016;23:1307-1318.Google Scholar
44.Zwerink, M, Effing, T, Kerstjens, HAM, et al. Cost-effectiveness of a community-based exercise programme in COPD self-management. COPD. 2016;13:214-223.Google Scholar
45.Coyle, D, Coyle, K, Kenny, GP, et al. Cost-effectiveness of exercise programs in type 2 diabetes. Int J Technol Assess Health Care. 2012;28:228-234.Google Scholar
Supplementary material: File

Guillon et al. supplementary material

Guillon et al. supplementary material 1

Download Guillon et al. supplementary material(File)
File 16.4 KB
Supplementary material: File

Guillon et al. supplementary material

Guillon et al. supplementary material 2

Download Guillon et al. supplementary material(File)
File 49.9 KB
Supplementary material: File

Guillon et al. supplementary material

Guillon et al. supplementary material 3

Download Guillon et al. supplementary material(File)
File 42.1 KB
Supplementary material: File

Guillon et al. supplementary material

Guillon et al. supplementary material 4

Download Guillon et al. supplementary material(File)
File 18.8 KB
Supplementary material: File

Guillon et al. supplementary material

Guillon et al. supplementary material 5

Download Guillon et al. supplementary material(File)
File 56 KB