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Title: Cost-utility of a cardiovascular prevention programme in highly educated adults: a randomised controlled trial
Authors: JACOBS, Nele 
CLAES, Neree 
EVERS, Silvia
Ament, Andre
Issue Date: 2009
Abstract: Objectives. Little is known about the costs and the effects of cardiovascular prevention programmes that are targeted at medical and behavioural risk factors and use computer tailoring. Methods. A general sample of 314 highly educated adults was recruited in Belgium and included in a randomised controlled trial of an intensive intervention and a standard intervention. Participants in the intensive intervention condition received medical assessments and could choose for behaviour change interventions (access to a tailored website, individual coaching and group sessions). Participants in the standard intervention condition received medical assessments for data collection. The latter condition was comparable to a preventive consultation in general practice following the guidelines. Cost data were registered from a health care perspective and the Short-Form 36© (SF-36), the International Physical Activity Questionnaire (IPAQ) and a validated fat intake questionnaire were used to measure effectiveness. Outcome measures were costs, quality adjusted life years (QALYs), the Incremental Cost-Effectiveness Ratio (ICER) and behaviour change. Non-parametric bootstrap analysis and sensitivity analyses were performed. Results. Of the participants, 219 completed the questionnaires at baseline, at 6 months and after one year. The ICER was €80.421/QALY when including the developmental costs of the intensive intervention. The incremental cost of the intensive intervention was €433 and the incremental effectiveness was 0,005 QALYs. The majority (69%) of the cost-effect pairs after bootstrap analysis were located in the northeast quadrant, suggesting more effect but at higher costs. Nevertheless, 31% of the cost-effect pairs were located in the northwest quadrant, suggesting higher costs without additional effect. Without the developmental costs of the intensive intervention, the ICER dropped to €21.055/QALY. For intensive physical activity and fat intake, however, 83% and 89% and of the cost-effect pairs were located in the northeast quadrant. Conclusions. The intensive intervention was not cost-effective compared to a standard intervention in a general sample of highly educated adults after one year of intervention. Perhaps cardiovascular prevention programmes cannot result in large QALY differences in healthy people on the short-term. Further research is needed to determine the cost-utility of this intervention for different target groups on the long-term.
Keywords: Gezondheid en welzijn
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ISSN: 1741-8267
Category: M
Type: Journal Contribution
Appears in Collections:Research publications

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