社区体重管理干预的效果和成本效益：健康体重管理示范的随机对照试验。

The efficacy and cost-effectiveness of a community weight management intervention: a randomized controlled trial of the health weight management demonstration.

机构信息

RTI International, Research Triangle Park, NC, USA.

出版信息

Prev Med. 2012 Jan;54(1):42-9. doi: 10.1016/j.ypmed.2011.09.018. Epub 2011 Oct 6.

DOI:10.1016/j.ypmed.2011.09.018

PMID:22001689

Abstract

PURPOSE

The study investigated the efficacy and cost-effectiveness of a cognitive-behavioral weight management program, complemented by an interactive Web site and brief telephone/e-mail coaching.

METHODS

In 2006-2007, 1755 overweight, non-active-duty TRICARE beneficiaries were randomized to one of three conditions with increasing intervention intensity: written materials and basic Web access (RCT1), plus an interactive Web site (RCT2), plus brief telephone/e-mail coaching support (RCT3). The study assessed changes in weight, blood pressure, and physical activity from baseline to 6, 12, and 15-18 months. (Study retention was 31% at 12 months.) Average and incremental cost-effectiveness and cost-offset analyses were conducted.

RESULTS

Participants experienced significant weight loss (-4.0%, -4.0%, and -5.3%, respectively, in each RCT group after 12 months and -3.5%, -3.8%, and -5.1%, respectively, after 15 to 18 months), increased physical activity, and decreased blood pressure. Cost-effectiveness ratios were $900 to $1100/quality-adjusted life year (QALY) for RCT1 and RCT2 and $1900/QALY for RCT3. The cost recovery period to the government was 3 years for RCTs 1 and 2 and 6 years for RCT3.

CONCLUSION

A relatively inexpensive cognitive-behavioral weight management intervention improved patient outcomes. Extrapolation of savings for the entire TRICARE population would significantly reduce direct medical costs.

摘要

目的

本研究旨在评估认知行为体重管理方案的疗效和成本效益，该方案辅以互动式网站和简短的电话/电子邮件辅导。

方法

在 2006-2007 年，1755 名超重、非现役 TRICARE 受益人均随机分为三组，干预强度逐渐增加：书面材料和基本网络访问（RCT1）、外加互动式网站（RCT2）、外加简短的电话/电子邮件辅导支持（RCT3）。该研究评估了从基线到 6、12 和 15-18 个月时体重、血压和身体活动的变化。（12 个月时的研究保留率为 31%）。进行了平均和增量成本效益和成本抵消分析。

结果

参与者的体重显著减轻（RCT1 组分别在 12 个月后减轻了 4.0%、4.0%和 5.3%，RCT2 组分别减轻了 3.5%、3.8%和 5.1%，RCT3 组分别减轻了 3.5%、3.8%和 5.1%，RCT3 组分别减轻了 5.1%），身体活动增加，血压降低。RCT1 和 RCT2 的成本效益比为每质量调整生命年（QALY）900 至 1100 美元，RCT3 为 1900 美元/QALY。对政府的成本回收期为 RCT1 和 RCT2 的 3 年，RCT3 的 6 年。