title: Are brief interventions to increase physical activity cost-effective? A systematic review.
abstract: OBJECTIVE
  To determine whether brief interventions promoting physical activity are cost-effective in primary care or community settings.
  
  
  METHODS
  Systematic review of economic evaluations.
  We searched MEDLINE, EMBASE, PsycINFO, CINAHL, EconLit, SPORTDiscus, PEDro, the Cochrane library, National Health Service Economic Evaluation Database and the Cost-Effectiveness Analysis Registry up to 20 August 2014. Web of Knowledge was used for cross-reference search. We included studies investigating the cost-effectiveness of brief interventions, as defined by National Institute for Health and Care Excellence, promoting physical activity in primary care or the community. Methodological quality was assessed using Drummond's checklist for economic evaluations. Data were extracted from individual studies fulfilling selection criteria using a standardised pro forma. Comparisons of cost-effectiveness and cost-utility ratios were made between studies.
  
  
  RESULTS
  Of 1840 identified publications, 13 studies fulfilled the inclusion criteria describing 14 brief interventions. Studies varied widely in the methods used, such as the perspective of economic analysis, intervention effects and outcome measures. The incremental cost of moving an inactive person to an active state, estimated for eight studies, ranged from £96 to £986. The cost-utility was estimated in nine studies compared with usual care and varied from £57 to £14 002 per quality-adjusted life year; dominant to £6500 per disability-adjusted life year; and £15 873 per life years gained.
  
  
  CONCLUSIONS
  Brief interventions promoting physical activity in primary care and the community are likely to be inexpensive compared with usual care. Given the commonly accepted thresholds, they appear to be cost-effective on the whole, although there is notable variation between studies.
authors.affiliation: Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.
authors.forename: Vijay
authors.initials: V
authors.lastname: GC
authors.affiliation: Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors.forename: Edward C F
authors.identifier: http://orcid.org/0000-0002-8369-1577
authors.initials: EC
authors.lastname: Wilson
authors.affiliation: Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, UK Centre for Health Economics, University of York, York, UK.
authors.forename: Marc
authors.initials: M
authors.lastname: Suhrcke
authors.affiliation: Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors.forename: Wendy
authors.initials: W
authors.lastname: Hardeman
authors.affiliation: Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sutton
mesh_terms: D003362:Cost-Benefit Analysis; D015444:Exercise; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic
keywords: Economics; Physical activity; Review