Cost‐effectiveness analysis of home‐based rehabilitation compared to usual care for people with inoperable lung cancer

Edbrooke, Lara; Denehy, Linda; Patrick, Cameron; Tuffaha, Haitham

doi:10.1111/ecc.13501

Cited by 6 publications

(3 citation statements)

References 55 publications

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“…Six of the eight included trials tested centre-based exercise programmes (hospital or community), however centre-based exercise programmes specific to lung cancer are rare in clinical practice. This is partly due to hospital-related barriers to delivery of such programmes including lack of funding, staffing and infrastructure12 13; patient-related barriers to access programmes including travel time and cost14; and lack of cost-effectiveness data 10 15. None of the trials were purely home-based 11.…”

Section: Introductionmentioning

confidence: 99%

“…Home-based exercise programmes for post-operative patients are an alternative model, although evidence is lacking 10. Home programmes are appealing in that they may be less resource intensive (although cost-effectiveness data of home programmes are lacking)10 15; they reduce the requirement for the patient to travel and allow flexibility for them to exercise within their own daily schedule14; and it supports the desire to shift more healthcare away from the hospital with potential health policy implications. Yet they may introduce new barriers such as a requirement for greater motivation from the individual to exercise on their own.…”

Section: Introductionmentioning

confidence: 99%

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Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial

et al. 2022

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IntroductionExercise is important in the postoperative management of lung cancer, yet no strong evidence exists for delivery of home-based programmes. Our feasibility (phase I) study established feasibility of a home-based exercise and self-management programme (the programme) delivered postoperatively. This efficacy (phase II) study aims to determine whether the programme, compared with usual care, is effective in improving physical function (primary outcome) in patients after lung cancer surgery.Methods and analysisThis will be a prospective, multisite, two-arm parallel 1:1, randomised controlled superiority trial with assessors blinded to group allocation. 112 participants scheduled for surgery for lung cancer will be recruited and randomised to usual care (no exercise programme) or, usual care plus the 12-week programme. The primary outcome is physical function measured with the EORTC QLQ c30 questionnaire. Secondary outcomes include health-related quality of life (HRQoL); exercise capacity; muscle strength; physical activity levels and patient reported outcomes. HRQoL and patient-reported outcomes will be measured to 12 months, and survival to 5 years. In a substudy, patient experience interviews will be conducted in a subgroup of intervention participants.Ethics and disseminationEthics approval was gained from all sites. Results will be submitted for publications in peer-reviewed journals.Trial registration numberACTRN12617001283369.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial

et al. 2022

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“…51,53,54, 56,57,59, 61, 62, 65, 66] as compared to modelled-based[50,52,55, 58, 60, 63].The outcome measures reported in the modelled-based economic evaluations of exercise interventions for cancer survivors were HrQol, weight, menopausal symptoms, risk of falls and disease-free survival[50,52,55, 58, 60, 63]. The effects of exercise on improving cardiovascular health have not been explored in economic evaluations of adult cancer survivors.…”

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confidence: 99%

Cost-Utility Analysis of a Supervised Exercise Intervention for Women with Early-Stage Endometrial Cancer

Wang

McCarthy

Tuffaha

2022

Preprint

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Purpose Cardiovascular disease (CVD) is the leading cause of death after treatment for endometrial cancer (EC). There is clinical evidence that exercise significantly reduces the risks of CVD and cancer recurrence; however, it is unclear whether there is value for money of integrating exercise into clinical cancer care for women treated for EC. This study aims to assess the long-term cost-effectiveness of a 12-week supervised exercise intervention for women diagnosed with early-stage EC compared to standard care. Method A cost-utility analysis was conducted from the Australian health system perspective. A Markov cohort model was designed with six mutually exclusive health states: i) No CVD, ii) Post-stroke, iii) Post-coronary heart diseases (CHD), iv) Post-heart failure, v) Post-cancer recurrence, vi) Death. The model was populated using the best available evidence in the literature. The cohort was followed for a time horizon of 5 years. Costs and outcomes were discounted at 5% annual rate. The incremental cost-effectiveness ratio (ICER) and net monetary benefit were estimated. Decision uncertainty was characterised using univariate and probabilistic sensitivity analysis. Result The incremental cost of supervised exercise versus standard care was AUD $496 and the incremental QALY was 0.064, resulting in an ICER of AUD $9,148 per QALY gained. The likelihood that the supervised exercise intervention was cost-effective at a willingness-to-pay threshold of AUD $50,000 per QALY was 97.8%. Conclusion This is the first economic evaluation of exercise after treatment for EC. The results suggest that exercise is cost-effective in this population. Implications for Cancer Survivors Given the low uncertainty in the results, efforts should focus on implementation of exercise as part of clinical cancer care.

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Economic evaluation of exercise interventions for individuals with cancer: A systematic review

Wang

McCarthy

Hayes

et al. 2023

Preventive Medicine

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Cost‐effectiveness analysis of home‐based rehabilitation compared to usual care for people with inoperable lung cancer

Cited by 6 publications

References 55 publications

Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial

Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial

Cost-Utility Analysis of a Supervised Exercise Intervention for Women with Early-Stage Endometrial Cancer

Economic evaluation of exercise interventions for individuals with cancer: A systematic review

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