Cost-effectiveness of Exercise Therapy in Patients with Intermittent Claudication: Supervised Exercise Therapy versus a ‘Go Home and Walk’ Advice

Abstract

At a willingness-to-pay threshold of € 40,000 per QALY, SET likely is a cost-effective therapeutic option for patients with claudication.

Illness Beliefs and Walking Behavior After Revascularization for Intermittent Claudication

“…4,5 Current treatment, including vascular intervention, supervised exercise programs, and 'go home and walk' advice, do not change physical activity behavior of PAD patients [6-10]. [6][7][8][9][10] As PAD typically involves multiple sites throughout the arteries, patient behavior change is important alongside vascular intervention to improve health and reduce the risk of cardiovascular comorbidity and mortality. Physically inactive patients with IC have twice the mortality risk of moderately physically active (1 to 3 hours per week moderate physical activity) patients over 5 years, suggesting that even low levels of physical activity would be beneficial for patients with IC [11].…”

Optimizing supervised exercise therapy for patients with intermittent claudication

“…In an earlier analysis, the mean cost for 1 year of physiotherapy was estimated at $1920.00 per year. 18 In conclusion, our study suggests that a supervised exercise program consisting of two or more training sessions a week each lasting over 30 minutes during the first 12 weeks of a program that is later tailored to the patient's needs, with a maximum duration of 1 year, seems to optimize walking distance after 3 and 12 months. …”

Peripheral Artery Disease in the Elderly: Prevalence, Clinical Implications, and Therapy

“…The mechanisms of improvement in walking distance following exercise training have yet to be fully elucidated; the reader is referred to Hamburg and Balady [84] for a comprehensive review on the topic. Most studies have indicated that supervised exercise training results in greater improvement in walking distance and cardiovascular risk profile and is more cost effective in terms of cost per quality-adjusted life year than unsupervised exercise training [85][86][87][88]. In contrast to these findings, a study by Gardner et al [89•] showed similar improvement in walking distance following a quantified home-based exercise program using accelerometers as compared to a supervised exercise program.…”