Ontology highlight
ABSTRACT: Objective
To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care.Design
Cost-utility analysis alongside a randomised controlled trial.Setting
Community settings in Greater London, England.Participants
174 young people with obesity aged 12-19 years.Interventions
Intervention participants received 12 one-to-one sessions across 6?months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice.Main outcome measures
Mean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC).Results
Mean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI -0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120?630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20?000 or £30?000 per QALY gained.Conclusions
We did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective.Trial registration number
ISRCTN9984011.
SUBMITTER: Panca M
PROVIDER: S-EPMC6124607 | biostudies-literature | 2018 Feb
REPOSITORIES: biostudies-literature
Panca Monica M Christie Deborah D Cole Tim J TJ Costa Silvia S Gregson John J Holt Rebecca R Hudson Lee D LD Kessel Anthony S AS Kinra Sanjay S Mathiot Anne A Nazareth Irwin I Wataranan Jay J Wong Ian Chi Kei ICK Viner Russell M RM Morris Stephen S
BMJ open 20180215 2
<h4>Objective</h4>To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care.<h4>Design</h4>Cost-utility analysis alongside a randomised controlled trial.<h4>Setting</h4>Community settings in Greater London, England.<h4>Participants</h4>174 young people with obesity aged 12-19 years.<h4>Interventions</h4>Intervention participants received 12 o ...[more]