Cardiorespiratory Fitness and Health Care Costs in Diabetes: The Veterans Exercise Testing Study

Myers, Jonathan; Silva, Christina Grüne de Souza e; Doom, Rachelle; Fonda, Holly; Chan, Khin; Kamil-Rosenberg, Shirit; Kokkinos, Peter

doi:10.1016/j.amjmed.2019.04.006

Cited by 20 publications

(15 citation statements)

References 34 publications

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“…Comparing medication data from the most and least fit quartiles was associated with 58% to 87% lower use of the classes of medications used (Williams & Franklin, 2007). Similarly, among men in the Veterans Exercise Testing Study, veterans in the highest quartile of fitness by direct treadmill testing had lower health care costs than men in the lowest quartile of fitness, but the contribution of medication costs were not detailed in these studies (de Souza de Silva et al, 2019;Myers et al, 2019).…”

Section: Discussionmentioning

confidence: 94%

Impact of Supervised Exercise on One-Year Medication Use in Older Veterans with Multiple Morbidities

Pepin

Valencia

Bettger

et al. 2020

Gerontology and Geriatric Medicine

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Exercise is touted as the ideal prescription to treat and prevent many chronic diseases. We examined changes in utilization and cost of medication classes commonly prescribed in the management of chronic conditions following participation in 12-months of supervised exercise within the Veterans Affairs Gerofit program. Gerofit enrolled 480 veterans between 1999 and 2017 with 12-months participation, with 453 having one or more active prescriptions on enrollment. Active prescriptions overall and for five classes of medications were examined. Changes from enrollment to 12 months were calculated, and cost associated with prescriptions filled were used to estimate net cost changes. Active prescriptions were reduced for opioids (77 of 164, 47%), mental health (93 of 221, 42%), cardiac (175 of 391, 45%), diabetes (41 of 166, 25%), and lipid lowering (56 of 253, 22%) agents. Cost estimates resulted in a net savings of $38,400. These findings support the role of supervised exercise as a favorable therapeutic intervention that has impact across chronic conditions.

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Section: Discussionmentioning

confidence: 94%

Impact of Supervised Exercise on One-Year Medication Use in Older Veterans with Multiple Morbidities

Pepin

Valencia

Bettger

et al. 2020

Gerontology and Geriatric Medicine

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“…[ 17 ] Our findings also share a number of similarities with recent findings, where higher fitness was associated with lower health care costs, which was more obvious among patients with diabetes. [ 30 ] That is, after adjusting for potential variables, the mean annual costs per patient over an 8-year period were found to be US$32178 lower among patients in the highest-fit than those in the least-fit category. In another study to assess a 10-year cost-effectiveness of lifestyle intervention and metformin for diabetes prevention, the Diabetes Prevention Program Research group observed a 17% relative reduction in inpatient health care costs in the lifestyle intervention group.…”

Section: Discussionmentioning

confidence: 99%

Physical activity is associated with lower health care costs among Taiwanese individuals with diabetes mellitus

Wang²,

et al. 2020

Medicine

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The economic burden of diabetes has increased over time with disease severity. Previous publications investigating the effects of physical activity (PA) on medical costs have made use of small sample sizes. We assessed the relationship between PA and 1-year medical expenditure among Taiwanese patients with type-2 diabetes mellitus (T2DM). Data were recruited from three governmental databases, including the 2012 adult preventive health service database. Participants were grouped as inactive (no exercise), insufficiently active (exercise < 150 minutes/week), and sufficiently active (exercise >150 minutes/week) individuals. Patients were stratified according to age and Charlson score. Multivariate linear regression models were used to determine β-coefficients and their P values. Overall, 218,960 individuals were identified with diabetes. The prevalence of the disease was 13.1% among sufficiently active, 35% among insufficiently active, and 51.9% among physically inactive adults. In general, patients who had exercise >150 minutes/week had lower health care spending (i.e., US$ 755.83) followed by those who had less than 150 minutes/week (US$ 880.08) when compared with inactive patients ( P < .0001). Moreover, health care costs derived from outpatient or inpatient care were lower for sufficiently active than inactive participants ( P < .0001). Compared with being sedentary, PA was associated with lower health care costs of Taiwanese adults with diabetes mellitus.

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“…We appreciate the comments from Dr. Haxhi et al related to our article on fitness and healthcare costs in those with diabetes 1 , and we could not agree more regarding the concept of investing in "METs not Meds." Although the importance of medications for appropriate patients should never be dismissed, the current clinical environment continues to emphasize treatment instead of prevention across the spectrum of chronic conditions.…”

Section: The Replymentioning

confidence: 90%

The Reply

Myers

Kokkinos

2019

The American Journal of Medicine

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Cardiorespiratory Fitness and Health Care Costs in Diabetes: The Veterans Exercise Testing Study

Cited by 20 publications

References 34 publications

Impact of Supervised Exercise on One-Year Medication Use in Older Veterans with Multiple Morbidities

Impact of Supervised Exercise on One-Year Medication Use in Older Veterans with Multiple Morbidities

Physical activity is associated with lower health care costs among Taiwanese individuals with diabetes mellitus

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