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Lifestyle interventions for knee pain in overweight and obese adults aged > or = 45: economic evaluation of randomised controlled trial

Lifestyle interventions for knee pain in overweight and obese adults aged > or = 45: economic evaluation of randomised controlled trial
Lifestyle interventions for knee pain in overweight and obese adults aged > or = 45: economic evaluation of randomised controlled trial
Objective: To estimate the cost effectiveness of four different lifestyle interventions for knee pain.
DESIGN: Cost utility analysis of randomised controlled trial.
Setting: Five general practices in the United Kingdom.PARTICIPANTS: 389 adults aged > or = 45 with self reported knee pain and body mass index (BMI) > or = 28.
Interventions: Dietary intervention plus quadriceps strengthening exercises, dietary intervention, quadriceps strengthening exercises, and leaflet provision. Participants received home visits over a two year period.
Main Outcome Measure: Incremental cost per quality adjusted life year (QALY) gained over two years from a health service perspective.
Results: Advice leaflet was associated with a mean change in cost of -31 pounds sterling, and a mean QALY gain of 0.085. Both strengthening exercises and dietary intervention were more effective (0.090 and 0.133 mean QALY gain, respectively) but were not cost effective. Dietary intervention plus strengthening exercises had a mean cost of 647 pounds sterling and a mean QALY gain of 0.147 and was estimated to have an incremental cost of 10,469 pounds sterling per QALY gain (relative to leaflet provision), and a 23.1% probability of being cost effective at a 20,000 pounds sterling/QALY threshold.
Conclusion: Dietary intervention plus strengthening exercises was estimated to be cost effective for individuals with knee pain, but with a large level of uncertainty.TRIAL REGISTRATION: ISRCTN93206785.
Aged, Arthralgia/economics, Body Mass Index, Cost-Benefit Analysis, Exercise Therapy/economics, Humans, Knee Joint, Life Style, Middle Aged, Obesity/diet therapy, Overweight/diet therapy, Pamphlets, Patient Education as Topic, Quadriceps Muscle, Quality-Adjusted Life Years, Treatment Outcome
0959-8138
Barton, Garry R
bf3455b3-9bee-4af6-94e8-930b2a383b33
Sach, Tracey H
5c09256f-ebed-4d14-853a-181f6c92d6f2
Jenkinson, Claire
3bf90b54-206f-4230-b44a-0c51a26cfa5b
Doherty, Michael
ab3e38b1-4e66-48b0-ae34-ec710c4fce2c
Avery, Anthony J
ba667df1-c7e8-4812-855c-8f5d8c37ed86
Muir, Kenneth R
4703d677-d4f5-4386-aa1e-2de40e31354f
Barton, Garry R
bf3455b3-9bee-4af6-94e8-930b2a383b33
Sach, Tracey H
5c09256f-ebed-4d14-853a-181f6c92d6f2
Jenkinson, Claire
3bf90b54-206f-4230-b44a-0c51a26cfa5b
Doherty, Michael
ab3e38b1-4e66-48b0-ae34-ec710c4fce2c
Avery, Anthony J
ba667df1-c7e8-4812-855c-8f5d8c37ed86
Muir, Kenneth R
4703d677-d4f5-4386-aa1e-2de40e31354f

Barton, Garry R, Sach, Tracey H, Jenkinson, Claire, Doherty, Michael, Avery, Anthony J and Muir, Kenneth R (2009) Lifestyle interventions for knee pain in overweight and obese adults aged > or = 45: economic evaluation of randomised controlled trial. BMJ (Clinical research ed.), 2009 (339), [b2273]. (doi:10.1136/bmj.b2273).

Record type: Article

Abstract

Objective: To estimate the cost effectiveness of four different lifestyle interventions for knee pain.
DESIGN: Cost utility analysis of randomised controlled trial.
Setting: Five general practices in the United Kingdom.PARTICIPANTS: 389 adults aged > or = 45 with self reported knee pain and body mass index (BMI) > or = 28.
Interventions: Dietary intervention plus quadriceps strengthening exercises, dietary intervention, quadriceps strengthening exercises, and leaflet provision. Participants received home visits over a two year period.
Main Outcome Measure: Incremental cost per quality adjusted life year (QALY) gained over two years from a health service perspective.
Results: Advice leaflet was associated with a mean change in cost of -31 pounds sterling, and a mean QALY gain of 0.085. Both strengthening exercises and dietary intervention were more effective (0.090 and 0.133 mean QALY gain, respectively) but were not cost effective. Dietary intervention plus strengthening exercises had a mean cost of 647 pounds sterling and a mean QALY gain of 0.147 and was estimated to have an incremental cost of 10,469 pounds sterling per QALY gain (relative to leaflet provision), and a 23.1% probability of being cost effective at a 20,000 pounds sterling/QALY threshold.
Conclusion: Dietary intervention plus strengthening exercises was estimated to be cost effective for individuals with knee pain, but with a large level of uncertainty.TRIAL REGISTRATION: ISRCTN93206785.

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More information

Accepted/In Press date: 12 December 2008
Published date: 18 August 2009
Keywords: Aged, Arthralgia/economics, Body Mass Index, Cost-Benefit Analysis, Exercise Therapy/economics, Humans, Knee Joint, Life Style, Middle Aged, Obesity/diet therapy, Overweight/diet therapy, Pamphlets, Patient Education as Topic, Quadriceps Muscle, Quality-Adjusted Life Years, Treatment Outcome

Identifiers

Local EPrints ID: 477001
URI: http://eprints.soton.ac.uk/id/eprint/477001
ISSN: 0959-8138
PURE UUID: f0a47ff6-e72d-4981-ae0a-fb5e6a4efd0a
ORCID for Tracey H Sach: ORCID iD orcid.org/0000-0002-8098-9220

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Date deposited: 23 May 2023 16:36
Last modified: 17 Mar 2024 04:19

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Contributors

Author: Garry R Barton
Author: Tracey H Sach ORCID iD
Author: Claire Jenkinson
Author: Michael Doherty
Author: Anthony J Avery
Author: Kenneth R Muir

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