Journal Article

Cost-effectiveness of a programme to address sedentary behaviour in older adults: results from the SITLESS RCT

Kee, Frank, Skjødt, Mathias, Guerra-Balic, Míriam, Rothenbacher, Dietrich, Roqué i Figuls, Marta, Tully, Mark A, McIntosh, Emma, Blackburn, Nicole E, Dallmeier, Dhayana, Deidda, Manuela, Coll-Planas, Laura, Caserotti, Paolo, Giné-Garriga, Maria

2022

Overview

Background This study details the within-trial economic evaluation and long-term economic model of SITLESS, a multi-country, three-armed randomized controlled trial comparing a combined intervention of exercise referral schemes (ERS) enhanced by self-management strategies (SMS) against ERS alone and usual care (UC). Methods A cost-utility analysis, conducted from the base-case perspective of the National Health Service and personal and social services, estimated the incremental cost per incremental quality-adjusted life year (QALY) and years in full capability (YFC). A secondary analysis combined the costs with a broad set of outcomes within a cost-consequence framework, from a societal perspective. A Markov-type decision-analytic model was developed to project short-term changes in physical activity to long-term outcomes and costs, over a 5- and 15-year time horizon. Results The results of the within-trial analysis show that SMS+ERS is highly likely to be cost-effective compared to ERS alone (ICER €4270/QALY), but not compared to UC. Participants allocated to the SMS+ERS group also showed an improvement in YFC compared to ERS alone and UC. The long-term analysis revealed that SMS+ERS is likely to be a cost-effective option compared to ERS and UC over a 5-year, but not with a 15-year horizon, being then dominated by ERS alone. Conclusion This research provides new evidence that SMS is a cost-effective add-on to ERS strategies. This economic evaluation informs the case for further, cost-effective, refinement of lifestyle change programmes targeted to older adults, with the aim of ultimately reducing the impact of non-communicable diseases in this population.

• Publisher: Oxford University Press
• Subject: Adults / Aged / Behavior modification / Cardiovascular Risk Factors / Care and treatment / Clinical trials / Cost analysis / Cost effectiveness / Cost-Benefit Analysis / Costs / Economic models / Economics / Exercise / Health aspects / Health care expenditures / Health promotion / Health services / Humans / Infectious diseases / Long term / Methods / Older people / Physical activity / Physical fitness / Quality adjusted life years / Secondary analysis / Sedentary / Sedentary Behavior / Self-care, Health / Selfmanagement / Social services / State Medicine / Testing / Time use / Utility functions