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Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care.

Verhaeghe N, De Smedt D, De Maeseneer J, Maes L, Van Heeringen C, Annemans L - BMC Public Health (2014)

Bottom Line: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case.Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY).The uncertainty associated with the intervention effect had the greatest impact on the model.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Ghent University, De Pintelaan 185 9000, Ghent, Belgium. nick.verhaeghe@ugent.be.

ABSTRACT

Background: There is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders.

Methods: A Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters.

Results: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model.

Conclusions: As far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.

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Related in: MedlinePlus

Markov decision-analytic model.
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Related In: Results  -  Collection

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Fig1: Markov decision-analytic model.

Mentions: The Markov model was based on a published model [17] and further developed using ©Microsoft Excel (Microsoft Corporation, Redmond, WA, US) to account for the specific context and characteristics of the current study. Nine possible states were included in the model (Figure 1): (i) population at risk (‘at risk’), (ii) type 2 diabetes (‘diabetes’), (iii) CHD, first year (‘CHD 1’), (iv) CHD, following years (‘CHD 1+’), (v) stroke, first year (‘stroke 1’), (vi) stroke, following years (‘stroke 1+’), (vii) colon cancer, first year (‘colon cancer 1’), (viii) colon cancer, following years (‘colon cancer 1+’), and (ix) dead (‘dead’). The time horizon of the model was 20 years including 20 one-year periods (called ‘cycles’).Figure 1


Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care.

Verhaeghe N, De Smedt D, De Maeseneer J, Maes L, Van Heeringen C, Annemans L - BMC Public Health (2014)

Markov decision-analytic model.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4150981&req=5

Fig1: Markov decision-analytic model.
Mentions: The Markov model was based on a published model [17] and further developed using ©Microsoft Excel (Microsoft Corporation, Redmond, WA, US) to account for the specific context and characteristics of the current study. Nine possible states were included in the model (Figure 1): (i) population at risk (‘at risk’), (ii) type 2 diabetes (‘diabetes’), (iii) CHD, first year (‘CHD 1’), (iv) CHD, following years (‘CHD 1+’), (v) stroke, first year (‘stroke 1’), (vi) stroke, following years (‘stroke 1+’), (vii) colon cancer, first year (‘colon cancer 1’), (viii) colon cancer, following years (‘colon cancer 1+’), and (ix) dead (‘dead’). The time horizon of the model was 20 years including 20 one-year periods (called ‘cycles’).Figure 1

Bottom Line: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case.Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY).The uncertainty associated with the intervention effect had the greatest impact on the model.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Ghent University, De Pintelaan 185 9000, Ghent, Belgium. nick.verhaeghe@ugent.be.

ABSTRACT

Background: There is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders.

Methods: A Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters.

Results: An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model.

Conclusions: As far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.

Show MeSH
Related in: MedlinePlus