Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: Protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial

M. Deidda, L. Coll-Planas, M. Giné-Garriga, M. Guerra-Balic, M.I. Roqué Figuls, M.A. Tully, P. Caserotti, D. Rothenbacher, A. Salvà Casanovas, F. Kee, Nicole Blackburn, J.J. Wilson, M. Skjødt, M. Denkinger, K. Wirth, E. McIntosh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction Promoting physical activity (PA) and reducing sedentary behaviour (SB) may exert beneficial effects on the older adult population, improving behavioural, functional, health and psychosocial outcomes in addition to reducing health, social care and personal costs. This paper describes the planned economic evaluation of SITLESS, a multicountry three-armed pragmatic randomised controlled trial (RCT) which aims to assess the short-term and long-term effectiveness and cost-effectiveness of a complex intervention on SB and PA in community-dwelling older adults, based on exercise referral schemes enhanced by a group intervention providing self-management strategies to encourage lifestyle change. Methods and analysis A within-trial economic evaluation and long-term model from both a National Health Service/personal social services perspective and a broader societal perspective will be undertaken alongside the SITLESS multinational RCT. Healthcare costs (hospitalisations, accident and emergency visits, appointment with health professionals) and social care costs (eg, community care) will be included in the economic evaluation. For the cost-utility analysis, quality-adjusted life-years will be measured using the EQ-5D-5L and capability well-being measured using the ICEpop CAPability measure for Older people (ICECAP-O) questionnaire. Other effectiveness outcomes (health related, behavioural, functional) will be incorporated into a cost-effectiveness analysis and cost-consequence analysis. The multinational nature of this RCT implies a hierarchical structure of the data and unobserved heterogeneity between clusters that needs to be adequately modelled with appropriate statistical and econometric techniques. In addition, a long-term population health economic model will be developed and will synthesise and extrapolate within-trial data with additional data extracted from the literature linking PA and SB outcomes with longer term health states. Methods guidance for population health economic evaluation will be adopted including the use of a long-time horizon, 1.5% discount rate for costs and benefits, cost consequence analysis framework and a multisector perspective.
LanguageEnglish
JournalBMJ Open
Volume8
Issue number10
DOIs
Publication statusPublished - 15 Oct 2018

Fingerprint

Self Care
Cost-Benefit Analysis
Referral and Consultation
Randomized Controlled Trials
Health
Costs and Cost Analysis
Population
Economic Models
Independent Living
Quality-Adjusted Life Years
National Health Programs
Social Work
Health Care Costs
Accidents
Life Style
Appointments and Schedules
Hospitalization
Emergencies
Delivery of Health Care

Keywords

  • complex interventions
  • economic evaluation
  • older adults
  • physical activity
  • sedentary behaviour
  • self-management strategies

Cite this

Deidda, M. ; Coll-Planas, L. ; Giné-Garriga, M. ; Guerra-Balic, M. ; Roqué Figuls, M.I. ; Tully, M.A. ; Caserotti, P. ; Rothenbacher, D. ; Salvà Casanovas, A. ; Kee, F. ; Blackburn, Nicole ; Wilson, J.J. ; Skjødt, M. ; Denkinger, M. ; Wirth, K. ; McIntosh, E. / Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: Protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial. In: BMJ Open. 2018 ; Vol. 8, No. 10.
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abstract = "Introduction Promoting physical activity (PA) and reducing sedentary behaviour (SB) may exert beneficial effects on the older adult population, improving behavioural, functional, health and psychosocial outcomes in addition to reducing health, social care and personal costs. This paper describes the planned economic evaluation of SITLESS, a multicountry three-armed pragmatic randomised controlled trial (RCT) which aims to assess the short-term and long-term effectiveness and cost-effectiveness of a complex intervention on SB and PA in community-dwelling older adults, based on exercise referral schemes enhanced by a group intervention providing self-management strategies to encourage lifestyle change. Methods and analysis A within-trial economic evaluation and long-term model from both a National Health Service/personal social services perspective and a broader societal perspective will be undertaken alongside the SITLESS multinational RCT. Healthcare costs (hospitalisations, accident and emergency visits, appointment with health professionals) and social care costs (eg, community care) will be included in the economic evaluation. For the cost-utility analysis, quality-adjusted life-years will be measured using the EQ-5D-5L and capability well-being measured using the ICEpop CAPability measure for Older people (ICECAP-O) questionnaire. Other effectiveness outcomes (health related, behavioural, functional) will be incorporated into a cost-effectiveness analysis and cost-consequence analysis. The multinational nature of this RCT implies a hierarchical structure of the data and unobserved heterogeneity between clusters that needs to be adequately modelled with appropriate statistical and econometric techniques. In addition, a long-term population health economic model will be developed and will synthesise and extrapolate within-trial data with additional data extracted from the literature linking PA and SB outcomes with longer term health states. Methods guidance for population health economic evaluation will be adopted including the use of a long-time horizon, 1.5{\%} discount rate for costs and benefits, cost consequence analysis framework and a multisector perspective.",
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Deidda, M, Coll-Planas, L, Giné-Garriga, M, Guerra-Balic, M, Roqué Figuls, MI, Tully, MA, Caserotti, P, Rothenbacher, D, Salvà Casanovas, A, Kee, F, Blackburn, N, Wilson, JJ, Skjødt, M, Denkinger, M, Wirth, K & McIntosh, E 2018, 'Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: Protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial', BMJ Open, vol. 8, no. 10. https://doi.org/10.1136/bmjopen-2018-022266

Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: Protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial. / Deidda, M.; Coll-Planas, L.; Giné-Garriga, M.; Guerra-Balic, M.; Roqué Figuls, M.I.; Tully, M.A.; Caserotti, P.; Rothenbacher, D.; Salvà Casanovas, A.; Kee, F.; Blackburn, Nicole; Wilson, J.J.; Skjødt, M.; Denkinger, M.; Wirth, K.; McIntosh, E.

In: BMJ Open, Vol. 8, No. 10, 15.10.2018.

Research output: Contribution to journalArticle

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T1 - Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: Protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial

AU - Deidda, M.

AU - Coll-Planas, L.

AU - Giné-Garriga, M.

AU - Guerra-Balic, M.

AU - Roqué Figuls, M.I.

AU - Tully, M.A.

AU - Caserotti, P.

AU - Rothenbacher, D.

AU - Salvà Casanovas, A.

AU - Kee, F.

AU - Blackburn, Nicole

AU - Wilson, J.J.

AU - Skjødt, M.

AU - Denkinger, M.

AU - Wirth, K.

AU - McIntosh, E.

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N2 - Introduction Promoting physical activity (PA) and reducing sedentary behaviour (SB) may exert beneficial effects on the older adult population, improving behavioural, functional, health and psychosocial outcomes in addition to reducing health, social care and personal costs. This paper describes the planned economic evaluation of SITLESS, a multicountry three-armed pragmatic randomised controlled trial (RCT) which aims to assess the short-term and long-term effectiveness and cost-effectiveness of a complex intervention on SB and PA in community-dwelling older adults, based on exercise referral schemes enhanced by a group intervention providing self-management strategies to encourage lifestyle change. Methods and analysis A within-trial economic evaluation and long-term model from both a National Health Service/personal social services perspective and a broader societal perspective will be undertaken alongside the SITLESS multinational RCT. Healthcare costs (hospitalisations, accident and emergency visits, appointment with health professionals) and social care costs (eg, community care) will be included in the economic evaluation. For the cost-utility analysis, quality-adjusted life-years will be measured using the EQ-5D-5L and capability well-being measured using the ICEpop CAPability measure for Older people (ICECAP-O) questionnaire. Other effectiveness outcomes (health related, behavioural, functional) will be incorporated into a cost-effectiveness analysis and cost-consequence analysis. The multinational nature of this RCT implies a hierarchical structure of the data and unobserved heterogeneity between clusters that needs to be adequately modelled with appropriate statistical and econometric techniques. In addition, a long-term population health economic model will be developed and will synthesise and extrapolate within-trial data with additional data extracted from the literature linking PA and SB outcomes with longer term health states. Methods guidance for population health economic evaluation will be adopted including the use of a long-time horizon, 1.5% discount rate for costs and benefits, cost consequence analysis framework and a multisector perspective.

AB - Introduction Promoting physical activity (PA) and reducing sedentary behaviour (SB) may exert beneficial effects on the older adult population, improving behavioural, functional, health and psychosocial outcomes in addition to reducing health, social care and personal costs. This paper describes the planned economic evaluation of SITLESS, a multicountry three-armed pragmatic randomised controlled trial (RCT) which aims to assess the short-term and long-term effectiveness and cost-effectiveness of a complex intervention on SB and PA in community-dwelling older adults, based on exercise referral schemes enhanced by a group intervention providing self-management strategies to encourage lifestyle change. Methods and analysis A within-trial economic evaluation and long-term model from both a National Health Service/personal social services perspective and a broader societal perspective will be undertaken alongside the SITLESS multinational RCT. Healthcare costs (hospitalisations, accident and emergency visits, appointment with health professionals) and social care costs (eg, community care) will be included in the economic evaluation. For the cost-utility analysis, quality-adjusted life-years will be measured using the EQ-5D-5L and capability well-being measured using the ICEpop CAPability measure for Older people (ICECAP-O) questionnaire. Other effectiveness outcomes (health related, behavioural, functional) will be incorporated into a cost-effectiveness analysis and cost-consequence analysis. The multinational nature of this RCT implies a hierarchical structure of the data and unobserved heterogeneity between clusters that needs to be adequately modelled with appropriate statistical and econometric techniques. In addition, a long-term population health economic model will be developed and will synthesise and extrapolate within-trial data with additional data extracted from the literature linking PA and SB outcomes with longer term health states. Methods guidance for population health economic evaluation will be adopted including the use of a long-time horizon, 1.5% discount rate for costs and benefits, cost consequence analysis framework and a multisector perspective.

KW - complex interventions

KW - economic evaluation

KW - older adults

KW - physical activity

KW - sedentary behaviour

KW - self-management strategies

U2 - 10.1136/bmjopen-2018-022266

DO - 10.1136/bmjopen-2018-022266

M3 - Article

VL - 8

JO - BMJ Open

T2 - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 10

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