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DC Field | Value | Language |
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dc.contributor.author | Anokye, N | - |
dc.contributor.author | Fox-Rushby, J | - |
dc.contributor.author | Sanghera, S | - |
dc.contributor.author | Cook, DG | - |
dc.contributor.author | Kerry, SM | - |
dc.contributor.author | Limb, E | - |
dc.contributor.author | Victor, CR | - |
dc.contributor.author | Iliffe, S | - |
dc.contributor.author | Shah, SM | - |
dc.contributor.author | Ussher, M | - |
dc.contributor.author | Whincup, PH | - |
dc.contributor.author | Ekelund, U | - |
dc.contributor.author | Furness, C | - |
dc.contributor.author | Ibison, J | - |
dc.contributor.author | DeWilde, S | - |
dc.contributor.author | David, L | - |
dc.contributor.author | Howard, E | - |
dc.contributor.author | Dale, R | - |
dc.contributor.author | Smith, J | - |
dc.contributor.author | Harris, TJ | - |
dc.date.accessioned | 2019-02-20T12:38:58Z | - |
dc.date.available | 2016-11 | - |
dc.date.available | 2019-02-20T12:38:58Z | - |
dc.date.issued | 2016-11-25 | - |
dc.identifier | S2 | - |
dc.identifier | S2 | - |
dc.identifier.citation | The Lancet, 2016, 388 pp. S19 - S19 | en_US |
dc.identifier.issn | S2 | - |
dc.identifier.issn | S2 | - |
dc.identifier.issn | 0140-6736 | - |
dc.identifier.issn | http://dx.doi.org/10.1016/S0140-6736(16)32255-3 | - |
dc.identifier.uri | http://bura.brunel.ac.uk/handle/2438/17513 | - |
dc.description.abstract | Background There is little evidence of the cost-effectiveness of pedometer-based interventions. We examined the short-term and long-term cost-effectiveness of a pedometer-based walking intervention in inactive adults. Methods Data were collected as part of a three-arm cluster-randomised trial conducted (2012–14) in seven primary care practices in London to assess the effectiveness of pedometer-based walking interventions (PACE-UP trial). Eligible participants were inactive adults aged 45–75 years, without contraindications to increasing moderate-tovigorous physical activity. 11 015 people were mailed an invitation. 6399 were non-responders, and 548 individuals who self-reported as being active were excluded. 1023 people were randomised to usual care (control, n=338), postal pedometer (339), and nurse-supported pedometer interventions (346). 956 participants (93%) provided outcome data. Intervention groups received pedometers, 12 week walking programmes, and diaries to record physical activity. The nurse group was also offered three physical activity consultations. A within trial cost-effectiveness analysis was done at 1 year. Additionally, a Markov model, using routine data obtained via reviews of epidemiological and economic literature, was used to extend trial results to a life-time horizon. Cost per change in physical activity (step count, and moderate-to-vigorous physical activity in ≥10 minute bouts) and quality-adjusted life-years (QALYs) for interventions were assessed. Costs (in 2013 prices) are presented from a health-care provider’s perspective and uncertainty as a costeff-ectiveness acceptability curve. Ethics approval was provided by London Research Ethics Committee (Hampstead). PACE-UP is registered with Current Controlled Trials, ISRCTN98538934. Findings In the short term, incremental cost per step and cost per min in a 10 min or more bout of moderate-to-vigorous physical activity were £0·19 and £3·61, respectively, for nurse-support. The postal group took a greater number of steps and cost less. In the long term, the postal group dominated both control and nurse groups in that QALY gains (759, 95% CI 400 to 1247) added to increased cost savings (–£11 million, 95% CI –12 to –10), resulting in an incremental net monetary benefit of £26 million (based on a hypothetical cohort of 100 000 people). The postal group had a 50% chance of being cost-effective in terms of QALYs at 1 year and, at a £20 000 per QALY threshold, robustly dominated both nurse and control groups in the long term. Interpretation A pedometer-based intervention delivered by post, compared with current practice, would deliver cost savings in the short term and the most quality of life benefits in the long term. | en_US |
dc.description.sponsorship | National Institute for Health Research Health Technology Assessment Programme | en_US |
dc.format.extent | S19 - S19 | - |
dc.language.iso | en | en_US |
dc.publisher | Elsevier | en_US |
dc.title | The short-term and long-term cost-effectiveness of a pedometer-based intervention in primary care: a within trial analysis and beyond-trial modelling | en_US |
dc.type | Conference Paper | en_US |
dc.identifier.doi | http://dx.doi.org/10.1016/S0140-6736(16)32255-3 | - |
dc.relation.isPartOf | The Lancet | - |
pubs.publication-status | Published | - |
pubs.volume | 388 | - |
Appears in Collections: | Dept of Health Sciences Research Papers |
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