title: Cost-effectiveness of exercise on prescription with telephone support among women in general practice over 2 years.
abstract: OBJECTIVE
  To assess the cost-effectiveness of exercise on prescription with ongoing support in general practice.
  
  
  METHODS
  Prospective cost-effectiveness study undertaken as part of the 2-year Women's lifestyle study randomised controlled trial involving 1089 'less-active' women aged 40-74. The 'enhanced Green Prescription' intervention included written exercise prescription and brief advice from a primary care nurse, face-to-face follow-up at 6 months, and 9 months of telephone support. The primary outcome was incremental cost of moving one 'less-active' person into the 'active' category over 24 months. Direct costs of programme delivery were recorded. Other (indirect) costs covered in the analyses included participant costs of exercise, costs of primary and secondary healthcare utilisation, allied health therapies and time off work (lost productivity). Cost-effectiveness ratios were calculated with and without including indirect costs.
  
  
  RESULTS
  Follow-up rates were 93% at 12 months and 89% at 24 months. Significant improvements in physical activity were found at 12 and 24 months (p<0.01). The exercise programme cost was New Zealand dollars (NZ$) 93.68 (€45.90) per participant. There was no significant difference in indirect costs over the course of the trial between the two groups (rate ratios: 0.99 (95% CI 0.81 to 1.2) at 12 months and 1.01 (95% CI 0.83 to 1.23) at 24 months, p=0.9). Cost-effectiveness ratios using programme costs were NZ$687 (€331) per person made 'active' and sustained at 12 months and NZ$1407 (€678) per person made 'active' and sustained at 24 months.
  
  
  CONCLUSIONS
  This nurse-delivered programme with ongoing support is very cost-effective and compares favourably with other primary care and community-based physical activity interventions internationally.
authors.affiliation: Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand. c.elley@auckland.ac.nz
authors.forename: C Raina
authors.initials: CR
authors.lastname: Elley
authors.forename: Sue
authors.initials: S
authors.lastname: Garrett
authors.forename: Sally B
authors.initials: SB
authors.lastname: Rose
authors.forename: Des
authors.initials: D
authors.lastname: O'Dea
authors.forename: Beverley A
authors.initials: BA
authors.lastname: Lawton
authors.forename: Simon A
authors.initials: SA
authors.lastname: Moyes
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Dowell
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000191:economics; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics; D005081:Exercise Therapy / Q000191:economics* / Q000451:nursing; D005260:Female; D058006:General Practice / Q000191:economics*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008875:Middle Aged; D009520:New Zealand; D055656:Prescriptions / Q000191:economics; D011446:Prospective Studies; D057185:Sedentary Behavior; D018582:Sick Leave / Q000191:economics; D012944:Social Support; D013689:Telephone / Q000191:economics*