Cost-effectiveness of exercise referral schemes: a systematic review of health economic studies.


Journal

European journal of public health
ISSN: 1464-360X
Titre abrégé: Eur J Public Health
Pays: England
ID NLM: 9204966

Informations de publication

Date de publication:
01 02 2022
Historique:
pubmed: 6 12 2021
medline: 5 4 2022
entrez: 5 12 2021
Statut: ppublish

Résumé

This systematic review aimed to provide an overview of the existing literature on cost-effectiveness of exercise referral schemes (ERSs). A systematic search was performed in MEDLINE, EMBASE, EconLit, Web of Science and PsycINFO. Main inclusion criteria were: (1) insufficiently active people; (2) ERSs and (3) full health economic evaluations. No publication year limits were applied. The methodological quality was assessed independently by two reviewers using the Consensus Health Economic Criteria (CHEC) checklist. Fifteen eligible publications were retrieved, presenting results of 12 different studies. Compared with usual care, ERSs were found to be cost-effective in a majority of the analyses, but with modest health gains and costs per individual. These cost-effectiveness results were also sensitive to small changes in input parameters. Two studies found that ERSs combined with a pedometer/accelerometer are cost-effective, compared with usual ERS practice. Two other studies found that an ERS with phone support and an ERS with face-to-face support might be equally effective, with similar costs. Although the literature demonstrated that ERSs could be cost-effective compared with usual care, these results were not robust. Based on a small number of studies, ERSs could be optimized by using tracking devices, or by providing a choice to the participants about the delivery mode. There is need for clarity on the effectiveness of and attendance to ERS, as more certainty about these key input parameters will strengthen health-economic evidence, and thus will allow to provide a clearer message to health policy-makers.

Sections du résumé

BACKGROUND
This systematic review aimed to provide an overview of the existing literature on cost-effectiveness of exercise referral schemes (ERSs).
METHODS
A systematic search was performed in MEDLINE, EMBASE, EconLit, Web of Science and PsycINFO. Main inclusion criteria were: (1) insufficiently active people; (2) ERSs and (3) full health economic evaluations. No publication year limits were applied. The methodological quality was assessed independently by two reviewers using the Consensus Health Economic Criteria (CHEC) checklist.
RESULTS
Fifteen eligible publications were retrieved, presenting results of 12 different studies. Compared with usual care, ERSs were found to be cost-effective in a majority of the analyses, but with modest health gains and costs per individual. These cost-effectiveness results were also sensitive to small changes in input parameters. Two studies found that ERSs combined with a pedometer/accelerometer are cost-effective, compared with usual ERS practice. Two other studies found that an ERS with phone support and an ERS with face-to-face support might be equally effective, with similar costs.
CONCLUSION
Although the literature demonstrated that ERSs could be cost-effective compared with usual care, these results were not robust. Based on a small number of studies, ERSs could be optimized by using tracking devices, or by providing a choice to the participants about the delivery mode. There is need for clarity on the effectiveness of and attendance to ERS, as more certainty about these key input parameters will strengthen health-economic evidence, and thus will allow to provide a clearer message to health policy-makers.

Identifiants

pubmed: 34864937
pii: 6449411
doi: 10.1093/eurpub/ckab189
pmc: PMC9090165
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

87-94

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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Auteurs

Amber Werbrouck (A)

Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, O&N2 Bus 521, Leuven 3000, Belgium.

Masja Schmidt (M)

Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.

Koen Putman (K)

Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.

Jan Seghers (J)

Department of Movement Sciences, KU Leuven, Tervuursevest 101 box 1500, Leuven 3001, Belgium.

Steven Simoens (S)

Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, O&N2 Bus 521, Leuven 3000, Belgium.

Nick Verhaeghe (N)

Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
HIVA Research Institute for Work and Society, KU Leuven, Parkstraat 47 Box 5300, Leuven 3000, Belgium.

Lieven Annemans (L)

Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.

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