Economic Evaluation of Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task Force

Details

• Alternative Title:
  Ann Intern Med
• Personal Author:
  Li, Rui ; Qu, Shuli ; Zhang, Ping ; Chattopadhyay, Sajal ; Gregg, Edward W. ; Albright, Ann ; Hopkins, David ; Pronk, Nicolaas P.
• Description:
  Background
  
  Diabetes is a highly prevalent and costly disease. Studies indicate that combined diet and physical activity promotion programs can prevent type 2 diabetes among persons at increased risk.
  
  Purpose
  
  To systematically evaluate the evidence on cost, cost-effectiveness, and cost-benefit estimates of diet and physical activity promotion programs.
  
  Data Sources
  
  Cochrane Library, EMBASE, MEDLINE, PsycINFO, Sociological Abstracts, Web of Science, EconLit, and CINAHL through 7 April 2015.
  
  Study Selection
  
  English-language studies from high-income countries that provided data on cost, cost-effectiveness, or cost-benefit ratios of diet and physical activity promotion programs with at least 2 sessions over at least 3 months delivered to persons at increased risk for type 2 diabetes.
  
  Data Extraction
  
  Dual abstraction and assessment of relevant study details.
  
  Data Synthesis
  
  Twenty-eight studies were included. Costs were expressed in 2013 U.S. dollars. The median program cost per participant was $653. Costs were lower for group-based programs (median, $417) and programs implemented in community or primary care settings (median, $424) than for the U.S. DPP (Diabetes Prevention Program) trial and the DPP Outcomes Study ($5881). Twenty-two studies assessed the incremental cost-effectiveness ratios (ICERs) of the programs. From a health system perspective, 16 studies reported a median ICER of $13 761 per quality-adjusted life-year (QALY) saved. Group-based programs were more cost-effective (median, $1819 per QALY) than those that used individual sessions (median, $15 846 per QALY). No cost-benefit studies were identified.
  
  Limitation
  
  Information on recruitment costs and cost-effectiveness of translational programs implemented in community and primary care settings was limited.
  
  Conclusion
  
  Diet and physical activity promotion programs to prevent type 2 diabetes are cost-effective among persons at increased risk. Costs are lower when programs are delivered to groups in community or primary care settings.
  
  Primary Funding Source
  
  None.
  
  
• Keywords:
  Cost-Benefit Analysis Diabetes Mellitus, Type 2 Diet, Reducing Exercise Health Promotion Humans Quality-Adjusted Life Years Risk Factors
• Source:
  Ann Intern Med. 163(6):452-460
• Pubmed ID:
  26167962
• Pubmed Central ID:
  PMC4913890
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  163
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bb15a6bda8f6bfd517ee0bb50ae1998fad9a45a8fd28ae24581774dc78da7bf2
• Download URL:
  https://stacks.cdc.gov/view/cdc/39994/cdc_39994_DS1.pdf
• File Type:
  [PDF - 360.87 KB ]