Cost-utility analysis of a randomized controlled weight loss trial among lactating overweight/obese women

BMC Public Health

Anna Winkvist¹  Fredrik Bertz¹  Hilde K Brekke¹  Lars A Hagberg² 

[1] Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, P.O Box 459, SE-405 30 Göteborg, Sweden;Centre for Health Care Science, Örebro University Hospital, Sweden and Örebro University, P.O.Box 1324, SE-701 13 Örebro, Sweden

关键词: Sweden;    Cost-effectiveness;    Lactation;    Obesity;    Intervention;    Diet;   

Others  :  1161345
DOI  :  10.1186/1471-2458-14-38

 received in 2013-09-06, accepted in 2014-01-04,  发布年份 2014

【 摘 要 】

Background

Overweight and obesity among young, adult women are increasing problems in Sweden as in many other countries. The postpartum period may be a good opportunity to improve eating habits and lose weight in a sustainable manner. The aim was to make a cost-utility analysis of a dietary behavior modification treatment alongside usual care, compared to usual care alone, among lactating overweight and obese women.

Methods

This study was a cost-utility analysis based on a randomized controlled and longitudinal clinical diet intervention. Between 2007-2010, 68 women living in Sweden were, after baseline measurement at 8-12 weeks postpartum, randomly assigned to a 12-week dietary behavior modification treatment or control group. Inclusion criteria were: self-reported pre-pregnancy body mass index (BMI) 25-35 kg/m², non-smoker, singleton term delivery, birth weight > 2500 g, intention to breastfeed for 6 mo and no diseases (mother and child). The women in the intervention group received 1.5 hour of individual counseling at study start and 1 hour at follow-up home visits after 6 weeks of intervention, with support through cell phone text messages every two wk. Dietary intervention aimed to reduce dietary intake by 500 kcal/day. The control group received usual care. Weight results have previously been reported. Here we report on analyses carried out during 2012-2013 of cost per quality adjusted life years (QALY), based on the changes in quality of life measured by EQ-5D-3 L and SF-6D. Likelihood of cost-effectiveness was calculated using Net Monetary Benefit method.

Results

Based on conservative assumptions of no remaining effect after 1 year follow-up, the diet intervention was cost-effective. Costs per gained QALY were 8 643 – 9 758 USD. The likelihood for cost-effectiveness, considering a willingness to pay 50 000 USD for a QALY, was 87–93%.

Conclusions

The diet intervention is cost-effective.

Trial registration

ClinicalTrials.gov Identifier:NCT01343238 Registered April 27, 2011.

The regional ethics committee in Gothenburg, Sweden, approved the study on November 15, 2006.

【 授权许可】

   
2014 Hagberg et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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