41943
document
Cost-effectiveness of a telephone-delivered intervention for physical activity and diet . BACKGROUND Given escalating rates of chronic disease , broad-reach and cost-effective interventions to increase physical activity and improve dietary intake are needed . The cost-effectiveness of a Telephone Counselling intervention to improve physical activity and diet , targeting adults with established chronic diseases in a low socio-economic area of a major Australian city was examined . METHODOLOGY/PRINCIPAL FINDINGS A cost-effectiveness modelling study using data collected between February 2005 and November 2007 from a cluster-randomised trial that compared Telephone Counselling with a " Usual Care " ( brief intervention ) alternative . Economic outcomes were assessed using a state-transition Markov model , which predicted the progress of participants through five health states relating to physical activity and dietary improvement , for ten years after recruitment . The costs and health benefits of Telephone Counselling , Usual Care and an existing practice ( Real Control ) group were compared . Telephone Counselling compared to Usual Care was not cost-effective ( $ 78,489 per quality adjusted life year gained ) . However , the Usual Care group did not represent existing practice and is not a useful comparator for decision making . Comparing Telephone Counselling outcomes to existing practice ( Real Control ) , the intervention was found to be cost-effective ( $ 29,375 per quality adjusted life year gained ) . Usual Care ( brief intervention ) compared to existing practice ( Real Control ) was also cost-effective ( $ 12,153 per quality adjusted life year gained ) . CONCLUSIONS/SIGNIFICANCE This modelling study shows that a decision to adopt a Telephone Counselling program over existing practice ( Real Control ) is likely to be cost-effective . Choosing the 'Usual Care ' brief intervention over existing practice ( Real Control ) shows a lower cost per quality adjusted life year , but the lack of supporting evidence for efficacy or sustainability is an important consideration for decision makers . The economics of behavioural approaches to improving health must be made explicit if decision makers are to be convinced that allocating resources toward such programs is worthwhile . TRIAL REGISTRATION This paper uses data collected in a previous clinical trial registered at the Australian Clinical Trials Registry , Australian New Zealand Clinical Trials Registry : Anzcrt.org.au ACTRN012607000195459 .
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Intervention_Educational
telephone-delivered intervention for physical activity and diet
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Intervention_Educational
Telephone Counselling intervention
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Intervention_Educational
Telephone Counselling
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Intervention_Physical
, Usual Care and an
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Intervention_Control
existing practice ( Real Control )
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Intervention_Educational
Telephone Counselling
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Intervention_Physical
Usual Care
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Intervention_Physical
Usual Care
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Intervention_Educational
Telephone Counselling
41953
Intervention_Control
existing practice ( Real Control )
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Intervention_Physical
'Usual Care ' brief intervention
41955
Outcome_Other
Cost-effectiveness
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Outcome_Other
cost-effectiveness
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Outcome_Other
Economic outcomes
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Outcome_Other
costs and health benefits
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Outcome_Other
Telephone Counselling
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Outcome_Other
cost-effective
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Outcome_Other
cost-effective
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Outcome_Other
cost-effective
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Outcome_Other
cost-effective
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Participant_Condition
physical activity and diet .
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Participant_Age
adults
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Participant_Condition
established chronic diseases
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Participant_Condition
low socio-economic area of a major Australian city