TY  - JOUR
AU  - Goranitis, I
AU  - Bellanca, L
AU  - Daley, AJ
AU  - Thomas, A
AU  - Stokes-Lampard, H
AU  - Roalfe, AK
AU  - Jowett, S
Y2  - 2020/12/18
Y1  - 2017/09/26
SN  - 1932-6203
UR  - http://hdl.handle.net/11343/256047
AB  - OBJECTIVE: To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. DESIGN: Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. SETTING: Primary care. POPULATION: Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. METHODS: An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. MAIN OUTCOME MEASURE: Cost per quality-adjusted life-year (QALY). RESULTS: Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. CONCLUSIONS: Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms.
LA  - English
PB  - PUBLIC LIBRARY SCIENCE
T1  - Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial
DO  - 10.1371/journal.pone.0184328
IS  - PLoS One
VL  - 12
IS  - 9
L1  - /bitstream/handle/11343/256047/PMC5614527.pdf?sequence=1&isAllowed=y
ER  -