Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence

Abstract

BackgroundThe health and economic burden of physical inactivity is well documented. A wide range of primary care and community-based interventions are available to increase physical activity. It is important to identify which components of these interventions provide the best value for money. AimTo assess the cost-effectiveness of physical activity interventions in primary care and the community. Design of studySystematic review of cost-effectiveness studies based on randomised controlled trials of interventions to increase adult physical activity that were based in primary health care or the community, completed between 2002 and 2009. MethodElectronic databases were searched to identify relevant literature. Results and study quality were assessed by two researchers, using Drummond's checklist for economic evaluations. Cost-effectiveness ratios for moving one person from inactive to active, and costutility ratios (cost per quality-adjusted life-year [QALY]) were compared between interventions.

A randomised controlled trial and cost-effectiveness evaluation of ‘booster’ interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

“…Three other recent systematic reviews [101][102][103] provide evidence that interventions in primary care, including brief interventions and telephone interventions, may be effective and/or cost-effective. The review by Orrow and colleagues 103 also mainly synthesised trials with self-reported activity as the primary outcome, but included all primary care interventions with at least 12 months' follow-up.…”

“…Of the eight studies reporting on the maintenance of behaviour change, two reported a maintenance effect for at least 50% of outcomes over 3 months without the intervention. Garrett and colleagues 101 reviewed cost-effectiveness studies of physical activity interventions in primary care and found that interventions involving advice (in person, by telephone or by mail) were more cost-effective than supervised exercise interventions. This review did not examine the marginal benefit of additional interventions to maintain behaviour change as the included studies all compared a specific intervention with usual practice or no intervention.…”

Effectiveness of a supervised physical activity programme on physical activity adherence in patients with cardiovascular risk factors

“…Primary care interventions based on PA are equally costeffective than drug interventions 32 and in most of the cases, could yield to more profound and sustainable gains in health than drugs. 33 In addition, existing randomised trial suggests that exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of cardiovascular diseases and prevention of diabetes.…”

Integrative Review of Nurse-delivered Community-Based Physical Activity Promotion

“…In addition, community-based PA interventions have been found to be more cost-effective than supervised exercise sessions (Garrett et al, 2011). Furthermore, a broad review of community-based PA interventions concluded that these interventions are most effective when some form of personal contact for intervention delivery is included (Bock, Jarczok, & Litaker, 2014).…”