Cost‐utility and cost‐effectiveness analyses of a long‐term, high‐intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis

Hout, Wilbert B. van den; Jong, Zuzana de; Munneke, Marten; Hazes, Johanna M. W.; Breedveld, Ferdinand C.; Vlieland, Thea Vliet

doi:10.1002/art.20903

Cited by 62 publications

(41 citation statements)

References 37 publications

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“…On the other hand, the Cost-Effectiveness Panel in Health and Medicine has been standing up for the use of values obtained from the community and not from patients, when conducting economic analyses 32 . The Brazier method has been more commonly used in recent studies, especially the most up-to-date version, from 2002, which may, in the future, contribute to improve the assessment of the SF-6D validity [33][34][35][36][37] . It is also interesting to highlight that both the methods that use the SF-36 questionnaire and those that use the SF-6D questionnaire present strong correlations with one another 14-18, 21, 27 .…”

Section: Discussionmentioning

confidence: 99%

O questionário SF-6D Brasil: modelos de construção e aplicações em economia da saúde

Campolina¹,

Bortoluzzo²,

Ferraz³

et al. 2010

Rev. Assoc. Med. Bras.

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objectIve. Compare the preference measures derived from the SF-36, based on the two Brazilian versions of the Short Form 6 Dimensions questionnaire -Brazil (SF-6D Brazil). Methods. Observational and transversal study. The following quality of life assessment instruments were applied: HAQ, SF-36, EQ-5D and SF-6D (1998 and 2002 versions). Descriptive statistics and correlation coefficients were used for data analysis. results. The study assessed 200 patients suffering from rheumatoid arthritis, with a mean age of 49.22 years, mean time with the disease of 11.16 years and mean HAQ score of 1.02. Preferences measured by the two versions of the SF-6D and by the EQ-5D showed significant correlations with one another, and Pearson coefficients ranged from 0.59 to 0.88 (p<0.01). conclusIon. The most current version of the SF-6D, based on the 2002 model, was found to be valid when compared to the version initially validated to Brazil and is a questionnaire alternative to assess preferences in economic analyses carried out in health care.

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Section: Discussionmentioning

confidence: 99%

O questionário SF-6D Brasil: modelos de construção e aplicações em economia da saúde

Campolina¹,

Bortoluzzo²,

Ferraz³

et al. 2010

Rev. Assoc. Med. Bras.

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“…Arthritis Patients In Training cohort (37), which are more expensive than home-based interventions (3), provided insufficient improvement to justify the additional costs as a medicoeconomic issue. An exercise program could be of particular interest to the elderly by reducing the risk of falls and fractures (38 -40) and by improving the cardiovascular disease risk profile (41).…”

Section: Baillet Et Almentioning

confidence: 99%

Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta‐analysis of randomized controlled trials

Baillet

Zeboulon

Gossec

et al. 2010

Arthritis Care & Research

177

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Objective. Several lines of evidence have emphasized an improvement in aerobic capacity and muscle strength after physical exercise programs in rheumatoid arthritis (RA) patients. Our objective was to evaluate the efficacy of aerobic exercises in RA on quality of life, function, and clinical and radiologic outcomes by a systematic literature review and a meta-analysis. Methods. A systematic literature search was performed in the Medline, EMBase, and Cochrane databases up to July 2009 and in the abstracts presented at rheumatology scientific meetings during the last 5 years. Randomized controlled trials (RCTs) comparing aerobic exercises with non-aerobic interventions in RA patients were included. Outcomes studied were postintervention quality of life, function assessed by the Health Assessment Questionnaire (HAQ), a pain visual analog scale (VAS), joint count, the Disease Activity Score in 28 joints (DAS28), and radiologic damage. Efficacy was assessed by standardized mean differences (SMDs; difference between groups of mean outcome variation from baseline/SD at baseline) of aerobic exercises versus non-aerobic rehabilitation. Heterogeneity was tested. SMDs were pooled by a meta-analysis using the inverse of variance model. Results. Fourteen RCTs, including 1,040 patients, met the inclusion criteria. Exercise improved the postintervention quality of life (SMD 0.39, P < 0.0001), HAQ score (SMD 0.24, P ‫؍‬ 0.0009), and pain VAS (SMD 0.31, P ‫؍‬ 0.02). Exercise in this RA population appeared safe, since global compliance, DAS28, and joint count were similar in both groups. Conclusion. Cardiorespiratory aerobic conditioning in stable RA appears to be safe and improves some of the most important outcome measures. However, the degree of the effect of aerobic exercise on the abovementioned parameters is small.

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“…The EQ-5D utility is a useful tool for calculating the number of quality adjusted life years gained and for making decisions for health managers and economists by comparing the cost utility of different treatments in several diseases (48). The current training program obtained relevant improvements in all 5 HRQOL dimensions.…”

mentioning

confidence: 99%

Exercise in waist‐high warm water decreases pain and improves health‐related quality of life and strength in the lower extremities in women with fibromyalgia

Gusi¹,

Tomás-Carús²,

Häkkinen³

et al. 2006

Arthritis & Rheumatism

138

105

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Objective. To evaluate the short-and long-term efficacy of exercise therapy in a warm, waist-high pool in women with fibromyalgia. Methods. Thirty-four women (mean ؎ SD tender points 17 ؎ 1) were randomly assigned to either an exercise group (n ‫؍‬ 17) to perform 3 weekly sessions of training including aerobic, proprioceptive, and strengthening exercises during 12 weeks, or to a control group (n ‫؍‬ 17). Maximal unilateral isokinetic strength was measured in the knee extensors and flexors in concentric and eccentric actions at 60°/second and 210°/second, and in the shoulder abductors and adductors in concentric contractions. Health-related quality of life (HRQOL) was assessed using the EQ-5D questionnaire; pain was assessed on a visual analog scale. All were measured at baseline, posttreatment, and after 6 months. Results. The strength of the knee extensors in concentric actions increased by 20% in both limbs after the training period, and these improvements were maintained after the de-training period in the exercise group. The strength of other muscle actions measured did not change. HRQOL improved by 93% (P ‫؍‬ 0.007) and pain was reduced by 29% (P ‫؍‬ 0.012) in the exercise group during the training, but pain returned close to the pretraining level during the subsequent de-training. However, there were no changes in the control group during the entire period. Conclusion. The therapy relieved pain and improved HRQOL and muscle strength in the lower limbs at low velocity in patients with initial low muscle strength and high number of tender points. Most of these improvements were maintained long term.

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Cost‐utility and cost‐effectiveness analyses of a long‐term, high‐intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis

Cited by 62 publications

References 37 publications

O questionário SF-6D Brasil: modelos de construção e aplicações em economia da saúde

O questionário SF-6D Brasil: modelos de construção e aplicações em economia da saúde

Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta‐analysis of randomized controlled trials

Exercise in waist‐high warm water decreases pain and improves health‐related quality of life and strength in the lower extremities in women with fibromyalgia

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