Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence
Open accessAbstract
BACKGROUND: The health and economic burden of physical inactivity is well documented. A wide range of primary care and community-based interventions are available to increase physical activity. It is important to identify which components of these interventions provide the best value for money. AIM: To assess the cost-effectiveness of physical activity interventions in primary care and the community. DESIGN OF STUDY: Systematic review of cost-effectiveness studies based on randomised controlled trials of interventions to increase adult physical activity that were based in primary health care or the community, completed between 2002 and 2009. METHOD: Electronic databases were searched to identify relevant literature. Results and study quality were assessed by two researchers, using Drummond's checklist for economic evaluations. Cost-effectiveness ratios for moving one person from inactive to active, and cost-utility ratios (cost per quality-adjusted life-year [QALY]) were compared between interventions. RESULTS: Thirteen studies fulfilled the inclusion criteria. Eight studies were of good or excellent quality. Interventions, study populations, and study designs were heterogeneous, making comparisons difficult. The cost to move one person to the 'active' category at 12 months was estimated for four interventions ranging from €331 to €3673. The cost-utility was estimated in nine studies, and varied from €348 to €86,877 per QALY. CONCLUSION: Most interventions to increase physical activity were cost-effective, especially where direct supervision or instruction was not required. Walking, exercise groups, or brief exercise advice on prescription delivered in person, or by phone or mail appeared to be more cost-effective than supervised gym-based exercise classes or instructor-led walking programmes. Many physical activity interventions had similar cost-utility estimates to funded pharmaceutical interventions and should be considered for funding at a similar level.
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Ambulatory interventions may be a cost-effective solution to reduce the negative consequences of excessive bed-time in hospitalised older adults.
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- Authors
- Garrett, S., Elley, C. R., Rose, S. B., O'Dea, D., Lawton, B. A., & Dowell, A. C.
- Affiliations
- University of Otago (NZ)
- University of Auckland (NZ)
- Venue
- British Journal of General Practice
- Published
- 2011-03-01
- Volume
- 61
- Issue
- 584
- Pages
- e125-e133
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC3047345
- OpenAlex
- W2043144072
- Cited by
- 223
- References
- 38
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 7 · 2023: 18 · 2022: 14 · 2021: 17 · 2020: 14 · 2019: 8 · 2018: 12 · 2017: 19 · 2016: 19 · 2015: 21 · 2014: 23 · 2013: 14 · 2012: 11
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Scheme for Promotion of Academic and Research Collaboration
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- physical activity interventions, cost-effectiveness, primary care, community-based intervention, physical inactivity, cost-utility analysis, quality-adjusted life years, walking program, exercise groups, exercise prescription, health economics
- MeSH terms
- Cost-Benefit Analysis, Health Promotion, Humans, Life Style, New Zealand, Physical Fitness, Primary Health Care, Quality of Life, Exercise, Randomized Controlled Trials as Topic
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