“As du Coeur” study: a randomized controlled trial on quality of life impact and cost effectiveness of a physical activity program in patients with cardiovascular disease

Abstract Background Physical activity programs (PAP) in patients with cardiovascular disease require evidence of cost-utility. To assess improvement in health-related quality of life (QoL) and reduction of health care consumption of patients following PAP, a randomized trial was used. Methods Patien...

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Main Authors: Laurent Bailly, Philippe Mossé, Stéphane Diagana, Marion Fournier, Fabienne d’Arripe-Longueville, Odile Diagana, Jocelyn Gal, Jean Grebet, Mario Moncada, Jean-Jacques Domerego, Rémi Radel, Roxane Fabre, Alain Fuch, Christian Pradier
Format: Article
Language:English
Published: BMC 2018-12-01
Series:BMC Cardiovascular Disorders
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Online Access:http://link.springer.com/article/10.1186/s12872-018-0973-3
Description
Summary:Abstract Background Physical activity programs (PAP) in patients with cardiovascular disease require evidence of cost-utility. To assess improvement in health-related quality of life (QoL) and reduction of health care consumption of patients following PAP, a randomized trial was used. Methods Patients from a health insurance company who had experienced coronary artery disease or moderate heart failure were invited to participate (N = 1891). Positive responders (N = 50) were randomly assigned to a progressively autonomous physical activity (PAPA) program or to a standard supervised physical activity (SPA) program. The SPA group had two supervised sessions per week over 5 months. PAPA group had one session per week and support to aid habit formation (written tips, exercise program, phone call). To measure health-related quality of life EQ-5D utility score were used, before intervention, 6 months (T6) and 1 year later. Health care costs were provided from reimbursement databases. Results Mobility, usual activities and discomfort improved significantly in both group (T6). One year later, EQ-5D utility score was improved in the PAPA group only. Total health care consumption in the intervention group decreased, from a mean of 4097 euros per year before intervention to 2877 euros per year after (p = 0.05), compared to a health care consumption of 4087 euros and 4180 euros per year, in the total population of patients (N = 1891) from the health insurance company. The incremental cost effectiveness ratio was 10,928 euros per QALYs. Conclusion A physical activity program is cost-effective in providing a better quality of life and reducing health care consumption in cardiovascular patients. Trial registration ISRCTN77313697, retrospectively registered on 20 November 2015.
ISSN:1471-2261