title: Lifestyle interventions for knee pain in overweight and obese adults aged > or = 45: economic evaluation of randomised controlled trial.
abstract: OBJECTIVE
  To estimate the cost effectiveness of four different lifestyle interventions for knee pain.
  
  
  METHODS
  Cost utility analysis of randomised controlled trial.
  
  
  METHODS
  Five general practices in the United Kingdom.
  
  
  METHODS
  389 adults aged > or = 45 with self reported knee pain and body mass index (BMI) > or = 28.
  
  
  METHODS
  Dietary intervention plus quadriceps strengthening exercises, dietary intervention, quadriceps strengthening exercises, and leaflet provision. Participants received home visits over a two year period.
  
  
  METHODS
  Incremental cost per quality adjusted life year (QALY) gained over two years from a health service perspective.
  
  
  RESULTS
  Advice leaflet was associated with a mean change in cost of -31 pounds sterling, and a mean QALY gain of 0.085. Both strengthening exercises and dietary intervention were more effective (0.090 and 0.133 mean QALY gain, respectively) but were not cost effective. Dietary intervention plus strengthening exercises had a mean cost of 647 pounds sterling and a mean QALY gain of 0.147 and was estimated to have an incremental cost of 10,469 pounds sterling per QALY gain (relative to leaflet provision), and a 23.1% probability of being cost effective at a 20,000 pounds sterling/QALY threshold.
  
  
  CONCLUSIONS
  Dietary intervention plus strengthening exercises was estimated to be cost effective for individuals with knee pain, but with a large level of uncertainty.
  
  
  BACKGROUND
  ISRCTN93206785.
authors.affiliation: Health Economics Group, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ.
authors.forename: Garry R
authors.initials: GR
authors.lastname: Barton
authors.forename: Tracey H
authors.initials: TH
authors.lastname: Sach
authors.forename: Claire
authors.initials: C
authors.lastname: Jenkinson
authors.forename: Michael
authors.initials: M
authors.lastname: Doherty
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Avery
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Muir
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000191:economics* / Q000517:prevention & control; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000191:economics*; D006801:Humans; D007719:Knee Joint; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000191:economics / Q000534:rehabilitation; D050177:Overweight / Q000178:diet therapy / Q000191:economics* / Q000534:rehabilitation; D010174:Pamphlets; D010353:Patient Education as Topic; D052097:Quadriceps Muscle; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome
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