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Cost-effectiveness of exercise on prescription with telephone support among women in general practice over 2 years
  1. C Raina Elley1,
  2. Sue Garrett2,
  3. Sally B Rose2,
  4. Des O'Dea3,
  5. Beverley A Lawton2,
  6. Simon A Moyes1,
  7. Anthony C Dowell4
  1. 1Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand
  2. 2Women's Health Research Centre, Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
  3. 3Department of Public Health, University of Otago, Wellington, New Zealand
  4. 4Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
  1. Correspondence to Dr C Raina Elley, Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand; c.elley{at}auckland.ac.nz

Abstract

Aim To assess the cost-effectiveness of exercise on prescription with ongoing support in general practice.

Methods Prospective cost-effectiveness study undertaken as part of the 2-year Women's lifestyle study randomised controlled trial involving 1089 ‘less-active’ women aged 40–74. The ‘enhanced Green Prescription’ intervention included written exercise prescription and brief advice from a primary care nurse, face-to-face follow-up at 6 months, and 9 months of telephone support. The primary outcome was incremental cost of moving one ‘less-active’ person into the ‘active’ category over 24 months. Direct costs of programme delivery were recorded. Other (indirect) costs covered in the analyses included participant costs of exercise, costs of primary and secondary healthcare utilisation, allied health therapies and time off work (lost productivity). Cost–effectiveness ratios were calculated with and without including indirect costs.

Results Follow-up rates were 93% at 12 months and 89% at 24 months. Significant improvements in physical activity were found at 12 and 24 months (p<0.01). The exercise programme cost was New Zealand dollars (NZ$) 93.68 (€45.90) per participant. There was no significant difference in indirect costs over the course of the trial between the two groups (rate ratios: 0.99 (95% CI 0.81 to 1.2) at 12 months and 1.01 (95% CI 0.83 to 1.23) at 24 months, p=0.9). Cost–effectiveness ratios using programme costs were NZ$687 (€331) per person made ‘active’ and sustained at 12 months and NZ$1407 (€678) per person made ‘active’ and sustained at 24 months.

Conclusions This nurse-delivered programme with ongoing support is very cost-effective and compares favourably with other primary care and community-based physical activity interventions internationally.

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Footnotes

  • Funding The cost-effectiveness analysis was funded by Sport and Recreation New Zealand (SPARC). The randomised controlled trial was funded by National Heart Foundation of New Zealand (grant 1091 and grant-in-aid 1091 and 1222), the Lottery Health Research Grants Board and the Maori Health Directorate (Ministry of Health).

  • Competing interests None.

  • Ethical approval This work was approved by the Central Region Ethics Committee 2004 (WGT/04/08/061).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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