Economic evaluation of a weight control program with e-mail and telephone counseling among overweight employees: a randomized controlled trial

Van, Dekkers J, Bosmans, Heymans, Hendriksen, Pronk

Description

Distance lifestyle counseling for weight control is a promising public health intervention in the work setting. Information about the cost-effectiveness of such interventions is lacking, but necessary to make informed implementation decisions. The purpose of this study was to perform an economic evaluation of a six-month program with lifestyle counseling aimed at weight reduction in an overweight working population with a two-year time horizon from a societal perspective. Methods A randomized controlled trial comparing a program with two modes of intervention delivery against self-help. 1386 Employees from seven companies participated (67% male, mean age 43 (SD 8.6) years, mean BMI 29.6 (SD 3.5) kg/m 2 ). All groups received self-directed lifestyle brochures. The two intervention groups additionally received a workbook-based program with phone counseling (phone; n=462) or a web-based program with e-mail counseling (internet; n=464). Body weight was measured at baseline and 24 months after baseline. Quality of life (EuroQol-5D) was assessed at baseline, 6, 12, 18 and 24 months after baseline. Resource use was measured with six-monthly diaries and valued with Dutch standard costs. Missing data were multiply imputed. Uncertainty around differences in costs and incremental cost-effectiveness ratios was estimated by applying non-parametric bootstrapping techniques and graphically plotting the results in cost-effectiveness planes and cost-effectiveness acceptability curves. Results At two years the incremental cost-effectiveness ratio was €1009/kg weight loss in the phone group and €16/kg weight loss in the internet group. The cost-utility analysis resulted in €245,243/quality adjusted life year (QALY) and €1337/QALY, respectively. The results from a complete-case analysis were slightly more favorable. However, there was considerable uncertainty around all outcomes. Conclusions Neither intervention mode was proven to be cost-effective compared to self-help. Trial registration ISRCTN04265725

Sujets

• Body weight
• Cost-effectiveness analysis
• Intervention
• Lifestyle
• RCT

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 11
• Langue: English

Extrait

Wieret al. International Journal of Behavioral Nutrition and Physical Activity2012,9:112 http://www.ijbnpa.org/content/9/1/112

R E S E A R C HOpen Access Economic evaluation of a weight control program with email and telephone counseling among overweight employees: a randomized controlled trial 1,2,3,4 1,3,4,53,6 2,3,6 Marieke F van Wier, J Caroline Dekkers, Judith E Bosmans, Martijn W Heymans, 4,7 81,3,4* 2,3,6 Ingrid JM Hendriksen, Nicolaas P Pronk , Willem van Mechelenand Maurits W van Tulder

Abstract Background:Distance lifestyle counseling for weight control is a promising public health intervention in the work setting. Information about the costeffectiveness of such interventions is lacking, but necessary to make informed implementation decisions. The purpose of this study was to perform an economic evaluation of a sixmonth program with lifestyle counseling aimed at weight reduction in an overweight working population with a twoyear time horizon from a societal perspective. Methods:A randomized controlled trial comparing a program with two modes of intervention delivery against selfhelp. 1386 Employees from seven companies participated (67% male, mean age 43 (SD 8.6) years, mean BMI 2 29.6 (SD 3.5) kg/m ). All groups received selfdirected lifestyle brochures. The two intervention groups additionally received a workbookbased program with phone counseling (phone; n=462) or a webbased program with email counseling (internet; n=464). Body weight was measured at baseline and 24 months after baseline. Quality of life (EuroQol5D) was assessed at baseline, 6, 12, 18 and 24 months after baseline. Resource use was measured with sixmonthly diaries and valued with Dutch standard costs. Missing data were multiply imputed. Uncertainty around differences in costs and incremental costeffectiveness ratios was estimated by applying nonparametric bootstrapping techniques and graphically plotting the results in costeffectiveness planes and costeffectiveness acceptability curves. Results:At two years the incremental costeffectiveness ratio was€1009/kg weight loss in the phone group and €16/kg weight loss in the internet group. The costutility analysis resulted in€245,243/quality adjusted life year (QALY) and€1337/QALY, respectively. The results from a completecase analysis were slightly more favorable. However, there was considerable uncertainty around all outcomes. Conclusions:Neither intervention mode was proven to be costeffective compared to selfhelp. Trial registration:ISRCTN04265725 Keywords:Body weight, Costeffectiveness, Costutility, Distance counseling, Intervention, Lifestyle, RCT, Workplace health promotion

* Correspondence: [e-mail] 1 Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands 3 EMGO Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands Full list of author information is available at the end of the article

© 2012 van Wier et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.