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Title: Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial)
Authors: Panca, Monica
Christie, Deborah
Cole, Tim J.
Costa, Silvia
Gregson, John
Holt, Rebecca
Hudson, Lee D.
Kessel, Anthony S.
Kinra, Sanjay
Mathiot, Anne
Nazareth, Irwin
Wataranan, Jay
Wong, Ian Chi Kei
Viner, Russell M.
Morris, Stephen
Issue Date: 2018
Publisher: © the Authors. Published by BMJ Publishing
Citation: PANCA, M. ... et al., 2018. Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial). BMJ OPEN, 8: e018640.
Abstract: Objective To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care. Design Cost-utility analysis alongside a randomised controlled trial. Setting Community settings in Greater London, England. Participants 174 young people with obesity aged 12–19 years. Interventions Intervention participants received 12 one to-one sessions across 6months, addressing lifestyle behaviours and focusing on motivation to change and self esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse delivered session providing didactic weight-management advice. Main outcome measures Mean costs and quality adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC). Results Mean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI −0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained. Conclusions We did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective.
Description: This is an Open Access Article. It is published by BMJ under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/by-nc/4.0/
Sponsor: This work was supported by the NIHR under its Programme Grants for Applied Research programme (Grant Reference Number RP-PG-0608-10035)—the Paediatric Research in Obesity Multi-model Intervention and Service Evaluation (PROMISE) programme). The HELP research team acknowledges the support of the NIHR through the Primary Care Research Network. TJC was funded by MRC grant MR/M012069/1.
Version: Published
DOI: 10.1136/bmjopen-2017-018640
URI: https://dspace.lboro.ac.uk/2134/35193
Publisher Link: https://doi.org/10.1136/bmjopen-2017-018640
ISSN: 2044-6055
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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