Show simple item record

dc.contributor.authorPanca, Monicaen
dc.contributor.authorChristie, Deborahen
dc.contributor.authorCole, Tim Jen
dc.contributor.authorNobre Da Costa, Silviaen
dc.contributor.authorGregson, Johnen
dc.contributor.authorHolt, Rebeccaen
dc.contributor.authorHudson, Lee Den
dc.contributor.authorKessel, Anthony Sen
dc.contributor.authorKinra, Sanjayen
dc.contributor.authorMathiot, Anneen
dc.contributor.authorNazareth, Irwinen
dc.contributor.authorWataranan, Jayen
dc.contributor.authorWong, Ian Chi Keien
dc.contributor.authorViner, Russell Men
dc.contributor.authorMorris, Stephenen
dc.date.accessioned2019-12-19T00:30:20Z
dc.date.available2019-12-19T00:30:20Z
dc.date.issued2018-02-15en
dc.identifier.issn2044-6055
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/300076
dc.description.abstractOBJECTIVE: To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care. DESIGN: Cost-utility analysis alongside a randomised controlled trial. SETTING: Community settings in Greater London, England. PARTICIPANTS: 174 young people with obesity aged 12-19 years. INTERVENTIONS: Intervention participants received 12 one-to-one sessions across 6 months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice. MAIN OUTCOME MEASURES: Mean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC). RESULTS: Mean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI -0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained. CONCLUSIONS: We did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective. TRIAL REGISTRATION NUMBER: ISRCTN9984011.
dc.description.sponsorshipThis work was supported by the NIHR under its Programme Grants for Applied Research programme (Grant Reference Number RP-PG-0608-10035)—the Paediatric Research in Obesity Multi-model Intervention and Service Evaluation (PROMISE) programme). The HELP research team acknowledges the support of the NIHR through the Primary Care Research Network. TJC was funded by MRC grant MR/M012069/1.
dc.format.mediumElectronicen
dc.languageengen
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumansen
dc.subjectObesityen
dc.subjectBody Weighten
dc.subjectWeight Lossen
dc.subjectMotivationen
dc.subjectSelf Concepten
dc.subjectResidence Characteristicsen
dc.subjectHealth Educationen
dc.subjectQuality-Adjusted Life Yearsen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectChilden
dc.subjectHealth Promotionen
dc.subjectCosts and Cost Analysisen
dc.subjectCost-Benefit Analysisen
dc.subjectLondonen
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectYoung Adulten
dc.subjectStandard of Careen
dc.subjectPediatric Obesityen
dc.subjectHealthy Lifestyleen
dc.subjectDiet, Healthyen
dc.titleCost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial).en
dc.typeArticle
prism.issueIdentifier2en
prism.publicationDate2018en
prism.publicationNameBMJ openen
prism.startingPagee018640
prism.volume8en
dc.identifier.doi10.17863/CAM.47150
dcterms.dateAccepted2018-01-18en
rioxxterms.versionofrecord10.1136/bmjopen-2017-018640en
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-02-15en
dc.contributor.orcidCole, Tim J [0000-0001-5711-8200]
dc.contributor.orcidCosta, Silvia [0000-0002-7774-6711]
dc.contributor.orcidNazareth, Irwin [0000-0003-2146-9628]
dc.contributor.orcidWong, Ian Chi Kei [0000-0001-8242-0014]
dc.contributor.orcidViner, Russell M [0000-0003-3047-2247]
dc.contributor.orcidMorris, Stephen [0000-0002-5828-3563]
dc.identifier.eissn2044-6055
rioxxterms.typeJournal Article/Reviewen


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record

Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International