AIM: Lifestyle intervention for high-risk CV patients saves money

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Adding an exercise regime, diet counseling and group meetings as a lifestyle intervention to the lives of adults at moderate or high risk for heart disease is cost-effective and can improve quality of life better than standard care methods, according to the results of a report published in the Sept. 13 issue of the Archives of Internal Medicine.

Margareta K. Eriksson, PhD, of Björknäs HealthCare Center, Boden, and Umeå University, Umeå, Sweden, and colleagues assessed the quality of life and costs of a three-year lifestyle intervention—exercise training, diet counseling and group meetings three times a week—in 151 patients at a high risk of CV disease in Sweden.

Six patients withdrew from the study and researchers assigned 71 patients to receive the lifestyle intervention and 74 were randomized to receive standard care, which consisted of patients receiving verbal and written information about diet and exercise. After the initial three-month intervention period, patients attended group meetings and were recommended to continue physical activity for at least 30 minutes per day.

The researchers found that costs differed for the two intervention styles. Costs were reported to be $337 higher for the intervention group compared to the control group—$197 financed by healthcare and $140 imposed on participants due to increased physical activity.

While costs were higher for the intervention arm, researchers also found that physician visits for this patient arm decreased by 28 percent per six months. Patients in the control arm made 10 percent more visits to their physicians per month.

The researchers concluded that this saved $384 in healthcare costs, which equated to a net savings of $47 per intervention patient. Additionally, the costs gained per quality of life years (QALY) not counted, were between $1,668 and $4,813.

"Probabilities of cost effectiveness were 89 percent to 100 percent when the amount of $50,000 was used as stakeholders' threshold of willingness to pay for a gained QALY," the authors wrote. "These results should be viewed in the context of the previously reported favorable impact on physical activity, fitness, waist circumference, waist-to-hip ratio, blood pressure and smoking cessation over the three-year period.

“Thus, high-intensity and long-lasting interventions can produce sustainable improvements in quality of life and can obviously be cost effective,” they concluded. “Such programs may be a wise use of resources in primary healthcare for patients with disease to which inactivity strongly contributes.”