Please use this identifier to cite or link to this item: http://buratest.brunel.ac.uk/handle/2438/7990
Title: Is brief advice in primary care a cost-effective way to promote physical activity?
Authors: Lord, J
Fox-Rushby, J
Keywords: Health promotion;Primary care;Physical activity;Brief advice
Issue Date: 2014
Publisher: BMJ Publishing Group Ltd
Citation: British Journal of Sports Medicine, 48(3): pp.202 - 206, (2014)
Abstract: Aim: This study models the cost-effectiveness of brief advice (BA) in primary care for physical activity (PA) addressing the limitations in the current limited economic literature through the use of a time-based modelling approach. Methods: A Markov model was used to compare the lifetime costs and outcomes of a cohort of 100 000 people exposed to BA versus usual care. Health outcomes were expressed in terms of quality-adjusted life years (QALYs). Costs were assessed from a health provider perspective (£2010/11 prices). Data to populate the model were derived from systematic literature reviews and the literature searches of economic evaluations that were conducted for national guidelines. Deterministic and probability sensitivity analyses explored the uncertainty in parameter estimates including short-term mental health gains associated with PA. Results: Compared with usual care, BA is more expensive, incurring additional costs of £806 809 but it is more effective leading to 466 QALYs gained in the total cohort, a QALY gain of 0.0047/person. The incremental cost per QALY of BA is £1730 (including mental health gains) and thus can be considered cost-effective at a threshold of £20 000/QALY. Most changes in assumptions resulted in the incremental cost-effectiveness ratio (ICER) falling at or below £12 000/QALY gained. However, when short-term mental health gains were excluded the ICER was £27 000/QALY gained. The probabilistic sensitivity analysis showed that, at a threshold of £20 000/QALY, there was a 99.9% chance that BA would be cost-effective. Conclusions: BA is a cost-effective way to improve PA among adults, provided short-term mental health gains are considered. Further research is required to provide more accurate evidence on factors contributing to the cost-effectiveness of BA.
Description: This article is made available through the Brunel Open Access Publishing Fund. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
URI: http://bjsm.bmj.com/content/48/3/202
http://bura.brunel.ac.uk/handle/2438/7990
DOI: http://dx.doi.org/10.1136/bjsports-2013-092897
ISSN: 1473-0480
Appears in Collections:Publications
Community Health and Public Health
Brunel OA Publishing Fund
Health Economics Research Group (HERG)

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