title: Cost-effectiveness of a Population-based Lifestyle Intervention to Promote Healthy Weight and Physical Activity in Non-attenders of Cardiac Rehabilitation.
abstract: BACKGROUND
  To evaluate the long-term cost-effectiveness of two home-based cardiac rehabilitation (CR) interventions (Healthy Weight (HW) and Physical Activity (PA)) for patients with cardiovascular disease (CVD), who had been referred to cardiac rehabilitation (CR) but had not attended. The interventions consisted of pedometer-based telephone coaching sessions on weight, nutrition and physical activity (HW group) or physical activity only (PA group) and were compared to a control group who received information brochures about physical activity.
  
  
  METHODS
  A cost-effectiveness analysis was conducted using data from two randomised controlled trials. One trial compared HW to PA (PANACHE study), and the second compared PA to usual care. A Markov model was developed which used one risk factor, body mass index (BMI) to determine the CVD risk level and mortality. Patient-level data from the trials were used to determine the transitions to CVD states and healthcare related costs. The model was run for separate cohorts of males and females. Univariate and probabilistic sensitivity analysis were conducted to test the robustness of the results.
  
  
  RESULTS
  Given a willingness-to-pay threshold of $50,000/QALY, in the long run, both the HW and PA interventions are cost-effective compared with usual care. While the HW intervention is more effective, it also costs more than both the PA intervention and the control group due to higher intervention costs. However, the HW intervention is still cost-effective relative to the PA intervention for both men and women. Sensitivity analysis suggests that the results are robust.
  
  
  CONCLUSIONS
  The results of this paper provide evidence of the long-term cost-effectiveness of home-based CR interventions for patients who are referred to CR but do not attend. Both the HW and PA interventions can be recommended as cost-effective home-based CR programs, especially for people lacking access to hospital services or who are unable to participate in traditional CR programs.
authors.affiliation: Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia. Electronic address: qinglu.cheng@qut.edu.au.
authors.forename: Qinglu
authors.initials: Q
authors.lastname: Cheng
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia. Electronic address: jody.church@chere.uts.edu.au.
authors.forename: Jody
authors.initials: J
authors.lastname: Church
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Haas
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Goodall
authors.affiliation: School of Dentistry and Health Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: Sangster
authors.affiliation: Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Furber
mesh_terms: D001835:Body Weight; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000191:economics* / Q000401:mortality; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D018803:Models, Economic; D009043:Motor Activity
keywords: Body Mass Index; Cardiovascular disease; Cost effectiveness; Pedometer; Rehabilitation; Telephone coaching