Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial
<strong>Objective</strong> To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. <strong>Design</strong> Economic evaluation taking a UK National Health Service and Personal Social Services perspective and...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
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Public Library of Science
2017
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| _version_ | 1797092909085884416 |
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| author | Goranitis, I Bellanca, L Daley, A Thomas, A Stokes-Lampard, H Roalfe, A Jowett, S |
| author_facet | Goranitis, I Bellanca, L Daley, A Thomas, A Stokes-Lampard, H Roalfe, A Jowett, S |
| author_sort | Goranitis, I |
| collection | OXFORD |
| description | <strong>Objective</strong> To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. <strong>Design</strong> Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. <strong>Setting</strong> Primary care. <strong>Population</strong> Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. <strong>Methods</strong> An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. <strong>Main outcome measure</strong> Cost per quality-adjusted life-year (QALY). <strong>Results</strong> Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. <strong>Conclusions</strong> Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms. |
| first_indexed | 2024-03-07T03:52:45Z |
| format | Journal article |
| id | oxford-uuid:c1d86057-b81e-4def-90ac-fbbb768468a3 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T03:52:45Z |
| publishDate | 2017 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:c1d86057-b81e-4def-90ac-fbbb768468a32022-03-27T06:04:31ZAerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c1d86057-b81e-4def-90ac-fbbb768468a3Symplectic Elements at OxfordPublic Library of Science2017Goranitis, IBellanca, LDaley, AThomas, AStokes-Lampard, HRoalfe, AJowett, S<strong>Objective</strong> To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. <strong>Design</strong> Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. <strong>Setting</strong> Primary care. <strong>Population</strong> Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. <strong>Methods</strong> An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. <strong>Main outcome measure</strong> Cost per quality-adjusted life-year (QALY). <strong>Results</strong> Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. <strong>Conclusions</strong> Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms. |
| spellingShingle | Goranitis, I Bellanca, L Daley, A Thomas, A Stokes-Lampard, H Roalfe, A Jowett, S Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial |
| title | Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial |
| title_full | Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial |
| title_fullStr | Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial |
| title_full_unstemmed | Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial |
| title_short | Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial |
| title_sort | aerobic exercise for vasomotor menopausal symptoms a cost utility analysis based on the active women trial |
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