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ABSTRACT: Objective
To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms.Design
Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective.Setting
Primary care.Population
Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ? 5 episodes of vasomotor symptoms daily.Methods
An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates.Main outcome measure
Cost per quality-adjusted life-year (QALY).Results
Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings.Conclusions
Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms.
SUBMITTER: Goranitis I
PROVIDER: S-EPMC5614527 | biostudies-literature | 2017
REPOSITORIES: biostudies-literature
Goranitis Ilias I Bellanca Leana L Daley Amanda J AJ Thomas Adele A Stokes-Lampard Helen H Roalfe Andrea K AK Jowett Sue S
PloS one 20170926 9
<h4>Objective</h4>To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms.<h4>Design</h4>Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective.<h4>Setting</h4>Primary care.<h4>Population</h4>Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily.<h4>Methods</h4>An individual and ...[more]