Skip to main content Accessibility help
×
Home

Cost-utility of a cardiovascular prevention program in highly educated adults: Intermediate results of a randomized controlled trial

  • Nele Jacobs (a1), Silvia Evers (a2), Andre Ament (a2) and Neree Claes (a1)

Abstract

Objectives: Little is known about the costs and the effects of cardiovascular prevention programs targeted at medical and behavioral risk factors. The aim was to evaluate the cost-utility of a cardiovascular prevention program in a general sample of highly educated adults after 1 year of intervention.

Methods: The participants were randomly assigned to intervention (n = 208) and usual care conditions (n = 106). The intervention consisted of medical interventions and optional behavior-change interventions (e.g., a tailored Web site). Cost data were registered from a healthcare perspective, and questionnaires were used to determine effectiveness (e.g., quality-adjusted life-years [QALYs]). A cost-utility analysis and sensitivity analyses using bootstrapping were performed on the intermediate results.

Results: When adjusting for baseline utility differences, the incremental cost was €433 and the incremental effectiveness was 0.016 QALYs. The incremental cost-effectiveness ratio was €26,910 per QALY.

Conclusions: The intervention was cost-effective compared with usual care in this sample of highly educated adults after 1 year of intervention. Increased participation would make this intervention highly cost-effective.

Copyright

References

Hide All
1. Aaronson, NK, Muller, M, Cohen, PD, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:10551068.
2. Ajzen, I. Theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179211.
3. Annemans, L, Lamotte, M, Clarys, P, Van Den Abeele, E. Health economic evaluation of controlled and maintained physical exercise in the prevention of cardiovascular and other prosperity diseases. Eur J Cardiovasc Prev Rehabil. 2007;14:815824.
4. Bemelmans, W, van Baal, P, Wendel-Vos, W, et al. The costs, effects and cost-effectiveness of counteracting overweight on a population level. A scientific base for policy targets for the Dutch national plan for action. Prev Med. 2008;46:127132.
5. Brazier, J, Roberts, J, Deverill, M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002;21:271292.
6. Claes, N, Jacobs, N. The PreCardio-study protocol—a randomized clinical trial of a multidisciplinary electronic cardiovascular prevention programme. BMC Cardiovasc Disord. 2007;7:27.
7. Claes, N, Moeremans, K, Frank, B, et al. Estimating the cost-effectiveness of quality-improving interventions in oral anticoagulation management within general practice. Value Health. 2006;9:369376.
8. De Backer, G, Ambrosioni, E, Borch-Johnsen, K, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2003;24:16011610.
9. De Bacquer, D, De Backer, G. The prevalence of concomitant hypertension and hypercholesterolaemia in the general population. Int J Cardiol. 2006;110:217223.
10. Gordon, L, Graves, N, Hawkes, A, Eakin, E. A review of the cost-effectiveness of face-to-face behavioural interventions for smoking, physical activity, diet and alcohol. Chronic Illn. 2007;3:101129.
11. Graves, N, McKinnon, L, Reeves, M, et al. Cost-effectiveness analyses and modelling the lifetime costs and benefits of health-behaviour interventions. Chronic Illn. 2006;2:97107.
12. Grover, SA, Coupal, L, Lowensteyn, I. Determining the cost-effectiveness of preventing cardiovascular disease: Are estimates calculated over the duration of a clinical trial adequate? Can J Cardiol. 2008;24:261266.
13. Gusi, N, Reyes, MC, Gonzalez-Guerrero, JL, et al. Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: A randomised controlled trial. BMC Public Health. 2008;8:231.
14. Jacobs, N, Claes, N. An autonomy-supporting cardiovascular prevention programme: Practical recommendations from self-determination theory. Eur Health Psychol. 2008;10:7476.
15. Kroeze, W, Werkman, A, Brug, J. A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Ann Behav Med. 2006;31:205–23.
16. Leal, J, Luengo-Fernandez, R, Gray, A, et al. Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J. 2006;27:16101619.
17. Manca, A, Hawkins, N, Sculpher, MJ. Estimating mean QALYs in trial-based cost-effectiveness analysis: The importance of controlling for baseline utility. Health Econ. 2005;14:487496.
18. Munro, JF, Nicholl, JP, Brazier, JE, et al. Cost effectiveness of a community based exercise programme in over 65 year olds: Cluster randomised trial. J Epidemiol Community Health. 2004;58:10041010.
19. National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal. Draft for consultation. London: NICE; 2007.
20. Ronckers, ET, Groot, W, Steenbakkers, M, et al. Costs of the ‘Hartslag Limburg’ community heart health intervention. BMC Public Health. 2006;6:51.
21. RVZ. Zinnige en duurzame zorg. Zoetermeer: Raad voor de Volksgezondheid en Zorg; 2006.
22. Ryan, RM, Deci, EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:6878.
23. van Keulen, HM, Mesters, I, Brug, J, et al. Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors. BMC Public Health. 2008;8:216.
24. Vandelanotte, C, De Bourdeaudhuij, I, Sallis, JF, et al. Efficacy of sequential or simultaneous interactive computer-tailored interventions for increasing physical activity and decreasing fat intake. Ann Behav Med. 2005;29:138146.
25. Vandelanotte, C, De Bourdeaudhuij, I, Philippaerts, R, Sjöström, M, Sallis, M. Reliability and validity of a computerized and Dutch version of the international physical activity questionnaire (IPAQ). J Phys Act Health. 2005;2:6375.
26. Vandelanotte, C, Matthys, C, De Bourdeaudhuij, I. Reliability and validity of a computerised questionnaire to measure fat intake in Belgium. Nutr Res. 2004;24:621631.
27. Walters, SJ, Brazier, JE. Sample sizes for the SF-6D preference based measure of health from the SF-36: A comparison of two methods. Health Serv Outcomes Res Methodol. 2003;4:3547.
28. WHO. The global burden of disease: 2004 update. Geneva: World Health Organization; 2008.

Keywords

Type Description Title
WORD
Supplementary materials

Jacobs et al. supplementary material
Supplementary tables and figure

 Word (270 KB)
270 KB

Cost-utility of a cardiovascular prevention program in highly educated adults: Intermediate results of a randomized controlled trial

  • Nele Jacobs (a1), Silvia Evers (a2), Andre Ament (a2) and Neree Claes (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed