Cost-effectiveness of a combined physical exercise and psychosocial training intervention for children with cancer: Results from the quality of life in motion study

Braam, Katja I.; Dijk-Lokkart, Elisabeth M. van; Dongen, Johanna M. van; Litsenburg, Raphaële R. L. van; Takken, Tim; Huisman, J.; Merks, Johannes H. M.; Bosmans, Judith E.; Hakkenbrak, Nadia A. G.; Bierings, Marc; Heuvel‐Eibrink, Marry M. van den; Veening, Margreet A.; Broeder, Eline van Dulmen‐den; Kaspers, Gertjan J. L.

doi:10.1111/ecc.12586

Cited by 15 publications

(39 citation statements)

References 33 publications

(50 reference statements)

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“…Finally, this was a post hoc analysis of the QLIM study in which no distinction was made between the intervention and the control group. Even though no significant effect of the combined physical exercise and psychosocial training program on physical fitness was found, there may have been some beneficial effects of participating in the QLIM study on an individual level that may have influenced our results.…”

Section: Discussionmentioning

confidence: 98%

“…There were no significant beneficial effects of the QLIM intervention on physical fitness, physical and psychosocial function at 4 and 12 months, except for a larger improvement in lower body muscle strength at 12 months in the intervention group. [26][27][28] Therefore, patients were evaluated together for the purpose of the present study, irrespective of the QLIM study group they were originally assigned to.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal development of cancer‐related fatigue and physical activity in childhood cancer patients

Dijk-Lokkart

Steur

Braam

et al. 2019

Pediatric Blood & Cancer

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Purpose Cancer‐related fatigue is one of the most distressing side effects of childhood cancer treatment. Physical activity can decrease fatigue and has positive effects on other health outcomes. Most research on physical activity pertains to adults, and the few studies that focus on children have limited follow‐up time. This study evaluates cancer‐related fatigue in children and its association with physical activity over a one‐year time period. Methods Sixty‐eight children with cancer (7–18 years) were recruited during or within the first year after treatment. Physical activity (Actical activity monitor) and cancer‐related fatigue (Pediatric Quality‐of‐Life Questionnaire Multidimensional Fatigue Scale (PedsQL‐MFS), self‐ and parent‐ reports) were assessed at baseline, 4 months, and 12 months. PedsQL‐MFS scores were compared with Dutch norms. Longitudinal association of cancer‐related fatigue with physical activity was evaluated (No. NTR 1531). Results Generally, PedsQL‐MFS scores were worse than norms at baseline and 4 months, and recovered by 12 months except for the parent‐proxy scores in adolescents. Younger children (≤12 years) self‐reported comparable or better scores than norms. Physical activity generally improved over time, but patients mostly remained sedentary. During follow‐up, increased physical activity was associated with less cancer‐related fatigue. Conclusion Cancer‐related fatigue in children improves over time, and increased physical activity is associated with less cancer‐related fatigue. Given the sedentary lifestyle of this population, the positive effect of physical activity on cancer‐related fatigue, and the many other health benefits of an active lifestyle, it is important to stimulate physical activity in childhood cancer patients and survivors.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Longitudinal development of cancer‐related fatigue and physical activity in childhood cancer patients

Dijk-Lokkart

Steur

Braam

et al. 2019

Pediatric Blood & Cancer

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“…This study, however, used modeling techniques, rather than patient-level data. Patient-level studies evaluating the cost-effectiveness of exercise interventions for patients with solid tumors provided mixed results [1, 10, 12, 17, 19, 35]. Kampshoff et al [12] found a 12-week high-intensity exercise intervention to be cost-effective compared with a moderate-intensity exercise intervention in a group of cancer survivors with solid tumors (mostly breast cancer), whereas May et al [17] found an 18-week exercise program to be cost-effective versus usual care for colon cancer, but not for breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…A previous systematic review on this topic [18] included only three studies. Since then, a small number of additional studies have evaluated the cost-effectiveness of exercise interventions during or after cancer treatment [1, 10, 12, 17, 19, 35], but they were heterogeneous in the type of cancer, type of intervention and control condition, study results, and/or they were not based on patient-level data. Given the importance of this topic and the scarcity of literature, more research on the cost-effectiveness of exercise interventions in patients with cancer is warranted.…”

Section: Introductionmentioning

confidence: 99%

Long-term effectiveness and cost-effectiveness of an 18-week supervised exercise program in patients treated with autologous stem cell transplantation: results from the EXIST study

et al. 2019

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Purpose To evaluate the long-term effectiveness and cost-effectiveness of a supervised 18-week high-intensity exercise program compared with usual care in patients treated with autologous stem cell transplantation. Methods One hundred nine patients were randomly assigned to the exercise intervention ( n = 54) or the usual care control group ( n = 55). Data on cardiorespiratory fitness (VO 2 peak), handgrip strength, general fatigue, and health-related quality of life (quality-adjusted life years [QALYs]) were collected at baseline (T0), after completion of the exercise intervention or at a similar time point in the control group (T1) and 12 months later (T2). Cost questionnaires were used to assess societal costs. Long-term effectiveness (at T2) was evaluated using linear mixed model analyses. For the economic evaluation, missing data were imputed using multiple imputation, and data were analyzed using linear mixed models. Results At T2, no statistically significant differences were found between the intervention and control group for VO 2 peak (0.12; 95%CI − 1.89; 2.14 ml/min/kg), handgrip strength (− 1.08; 95%CI− 2.47; 2.31), and general fatigue (− 0.69; 95%CI − 2.52; 1.14). During 12-months follow-up, no significant between-group differences in QALYs and societal costs were found (QALYs − 0.07; 95%CI − 0.17; 0.04; costs 529; 95%CI − 3205;4452). Intervention costs were €1340 per patient. For all outcomes, the probability of the intervention being cost-effective was low at reasonable values of willingness-to-pay. Conclusion We found no evidence for the exercise intervention being effective on physical fitness and fatigue, nor cost-effective from a societal perspective. Trial registration The study was prospectively registered on 27 May 2010 at the Netherlands Trial Register ( NTR2341 ). Implications for Cancer Survivors The current exercise intervention should not be recommended to patients recently treated with autologous stem cell transplantation.

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“…Therefore, as far as possible, analysts should refrain from synthesising utilities with heterogeneous treatment status and post-treatment time profiles, although this can be difficult if primary studies do not offer adequate information, especially for chronic disease health states. In the context of a longitudinal experimental study, such as that by Braam and colleagues[68], analysts could treat baseline utilities from both intervention and control groups as estimates of utility for paediatric cancer survivors not confounded by any postcancer treatment. These utilities could potentially be synthesised with comparable utilities for paediatric cancer survivors from other studies similarly not confounded by any further treatment.…”

mentioning

confidence: 99%

A Practical Guide to Conducting a Systematic Review and Meta-analysis of Health State Utility Values

2018

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Economic analysts are increasingly likely to rely on systematic reviews and meta-analyses of health state utility values to inform the parameter inputs of decision-analytic modelling-based economic evaluations. Beyond the context of economic evaluation, evidence from systematic reviews and meta-analyses of health state utility values can be used to inform broader health policy decisions. This paper provides practical guidance on how to conduct a systematic review and meta-analysis of health state utility values. The paper outlines a number of stages in conducting a systematic review, including identifying the appropriate evidence, study selection, data extraction and presentation, and quality and relevance assessment. The paper outlines three broad approaches that can be used to synthesise multiple estimates of health utilities for a given health state or condition, namely fixed-effect meta-analysis, random-effects meta-analysis and mixed-effects meta-regression. Each approach is illustrated by a synthesis of utility values for a hypothetical decision problem, and software code is provided. The paper highlights a number of methodological issues pertinent to the conduct of meta-analysis or meta-regression. These include the importance of limiting synthesis to 'comparable' utility estimates, for example those derived using common utility measurement approaches and sources of valuation; the effects of reliance on limited or poorly reported published data from primary utility assessment studies; the use of aggregate outcomes within analyses; approaches to generating measures of uncertainty; handling of median utility values; challenges surrounding the disentanglement of utility estimates collected serially within the context of prospective observational studies or prospective randomised trials; challenges surrounding the disentanglement of intervention effects; and approaches to measuring model validity. Areas of methodological debate and avenues for future research are highlighted.

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Cost-effectiveness of a combined physical exercise and psychosocial training intervention for children with cancer: Results from the quality of life in motion study

Cited by 15 publications

References 33 publications

Longitudinal development of cancer‐related fatigue and physical activity in childhood cancer patients

Longitudinal development of cancer‐related fatigue and physical activity in childhood cancer patients

Long-term effectiveness and cost-effectiveness of an 18-week supervised exercise program in patients treated with autologous stem cell transplantation: results from the EXIST study

A Practical Guide to Conducting a Systematic Review and Meta-analysis of Health State Utility Values

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