Cost-effectiveness of a programme to address sedentary behaviour in older adults: results from the SITLESS RCT

Deidda, M. et al. (2022) Cost-effectiveness of a programme to address sedentary behaviour in older adults: results from the SITLESS RCT. European Journal of Public Health, 32(3), pp. 415-421. (doi: 10.1093/eurpub/ckac017) (PMID:35426903) (PMCID:PMC9159313)

Abstract

Background: This study details the within-trial economic evaluation and long-term economic model of SITLESS, a multi-country, three-armed randomized controlled trial comparing a combined intervention of exercise referral schemes (ERS) enhanced by self-management strategies (SMS) against ERS alone and usual care (UC). Methods: A cost-utility analysis, conducted from the base-case perspective of the National Health Service and personal and social services, estimated the incremental cost per incremental quality-adjusted life year (QALY) and years in full capability (YFC). A secondary analysis combined the costs with a broad set of outcomes within a cost-consequence framework, from a societal perspective. A Markov-type decision-analytic model was developed to project short-term changes in physical activity to long-term outcomes and costs, over a 5- and 15-year time horizon. Results: The results of the within-trial analysis show that SMS+ERS is highly likely to be cost-effective compared to ERS alone (ICER €4270/QALY), but not compared to UC. Participants allocated to the SMS+ERS group also showed an improvement in YFC compared to ERS alone and UC. The long-term analysis revealed that SMS+ERS is likely to be a cost-effective option compared to ERS and UC over a 5-year, but not with a 15-year horizon, being then dominated by ERS alone. Conclusion: This research provides new evidence that SMS is a cost-effective add-on to ERS strategies. This economic evaluation informs the case for further, cost-effective, refinement of lifestyle change programmes targeted to older adults, with the aim of ultimately reducing the impact of non-communicable diseases in this population.

• Item Type: Articles
• Additional Information: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 634270.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McIntosh, Professor Emma and Deidda, Dr Manuela
• Authors: Deidda, M., Coll-Planas, L., Tully, M. A., Giné-Garriga, M., Kee, F., Roqué i Figuls, M., Blackburn, N. E., Guerra-Balic, M., Rothenbacher, D., Dallmeier, D., Caserotti, P., Skjødt, M., and McIntosh, E.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
• Journal Name: European Journal of Public Health
• Publisher: Oxford University Press
• ISSN: 1101-1262
• ISSN (Online): 1464-360X
• Published Online: 15 April 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in European Journal of Public Health 32(3): 415-421
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
171947		SITLESS	Emma McIntosh	European Commission (EC)	Horizon 2020 Sitless	HW - Health Economics and Health Technology Assessment