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Are education, exercise and diet interventions a cost-effective treatment to manage hip and knee osteoarthritis? A systematic review.
Mazzei, D R; Ademola, A; Abbott, J H; Sajobi, T; Hildebrand, K; Marshall, D A.
Afiliación
  • Mazzei DR; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute of Public Health, Cumming School of Medicin
  • Ademola A; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute of Public Health, Cumming School of Medicin
  • Abbott JH; Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand. Electronic address: haxby.abbott@otago.ac.nz.
  • Sajobi T; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: ttsajobi@ucalgary.ca.
  • Hildebrand K; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Surgery, Cumming School of Medicine, University
  • Marshall DA; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute of Public Health, Cumming School of Medicin
Osteoarthritis Cartilage ; 29(4): 456-470, 2021 04.
Article en En | MEDLINE | ID: mdl-33197558
OBJECTIVE: To identify research gaps and inform implementation we systematically reviewed the literature evaluating cost-effectiveness of recommended treatments (education, exercise and diet) for the management of hip and/or knee OA. METHODS: We searched Medline, Embase, Cochrane Central Register of Controlled Trials, National Health Services Economic Evaluation Database, and EconLit from inception to November 2019 for trial-based economic evaluations investigating hip and/or knee OA core treatments. Two investigators screened relevant publications, extracted data and synthesized results. Risk of bias was assessed using the Consensus on Health Economic Criteria list. RESULTS: Two cost-minimization, five cost-effectiveness and 16 cost-utility analyses evaluated core treatments in six health systems. Exercise therapy with and without education or diet was cost-effective or cost-saving compared to education or physician-delivered usual care at conventional willingness to pay (WTP) thresholds in 15 out of 16 publications. Exercise interventions were cost-effective compared to physiotherapist-delivered usual care in three studies at conventional WTP thresholds. Education interventions were not cost-effective compared to usual care or placebo at conventional WTP thresholds in three out of four publications. CONCLUSIONS: Structured core treatment programs were clinically effective and cost-effective, compared to physician-delivered usual care, in five health care systems. Providing education about core treatments was not consistently cost-effective. Implementing structured core treatment programs into funded clinical pathways would likely be an efficient use of health system resources and enhance physician-delivered usual primary care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis de la Cadera / Educación del Paciente como Asunto / Osteoartritis de la Rodilla / Dietoterapia / Terapia por Ejercicio Tipo de estudio: Clinical_trials / Guideline / Health_economic_evaluation / Prognostic_studies / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Osteoarthritis Cartilage Asunto de la revista: ORTOPEDIA / REUMATOLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis de la Cadera / Educación del Paciente como Asunto / Osteoartritis de la Rodilla / Dietoterapia / Terapia por Ejercicio Tipo de estudio: Clinical_trials / Guideline / Health_economic_evaluation / Prognostic_studies / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Osteoarthritis Cartilage Asunto de la revista: ORTOPEDIA / REUMATOLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido