King's Health Economics (KHE), Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Br J Psychiatry. 2023 Aug;223(2):362-376. doi: 10.1192/bjp.2023.52. Epub 2023 Aug 1.
Clinical guidelines recommend providing physical activity interventions (PAIs) to people with schizophrenia or bipolar disorder for weight management. However, the cost-effectiveness of PAIs is unknown.
To evaluate the availability and methodological quality of economic evaluations of PAIs for people with schizophrenia or bipolar disorder.
Four databases (MEDLINE, Embase, PsycInfo and Scopus) were searched on 5 July 2022. Based on the retrieved studies, forward and backward citation searches were conducted. Two reviewers independently selected studies for inclusion. Study quality was assessed using the Drummond checklist. Review results were presented using narrative synthesis.
Fourteen articles reporting nine studies were included. All included studies assessed PAIs within a multicomponent lifestyle intervention. Mixed findings were reported on the cost-effectiveness of multicomponent lifestyle intervention: three studies reported it as cost-effective; four studies reported it as not cost-effective; and two studies did not conclude whether it was cost-effective or not. Very limited evidence suggests that certain patient subgroups might be more likely to benefit from multicomponent lifestyle interventions with a PAI component: men; individuals with comorbid type 2 diabetes; and individuals who have been psychiatric hospital in-patients for ≥1 year. The quality of included studies ranged from moderate to high.
The current economic evidence suggests that not all modalities of multicomponent lifestyle intervention including a PAI component are cost-effective for people with schizophrenia or bipolar disorder; and not all people with schizophrenia or bipolar disorder would benefit equally from the intervention. Future research is urgently needed to identify the cost-effective modality of PAI for different patient subgroups.
临床指南建议为患有精神分裂症或双相情感障碍的患者提供身体活动干预（PAI）以进行体重管理。然而，PAI 的成本效益尚不清楚。
评估针对精神分裂症或双相情感障碍患者的 PAI 的经济评估的可用性和方法学质量。
于 2022 年 7 月 5 日在 MEDLINE、Embase、PsycInfo 和 Scopus 这四个数据库中进行了检索。基于检索到的研究，进行了正向和反向引文搜索。两名审查员独立选择纳入的研究。使用 Drummond 清单评估研究质量。使用叙述性综合法呈现审查结果。
纳入了 14 篇报道了 9 项研究的文章。所有纳入的研究均评估了多组分生活方式干预中的 PAI。多组分生活方式干预的成本效益结果存在混合发现：三项研究报告其具有成本效益；四项研究报告其不具有成本效益；两项研究未得出其是否具有成本效益的结论。有非常有限的证据表明，某些患者亚组可能更有可能从包含 PAI 成分的多组分生活方式干预中获益：男性；合并 2 型糖尿病的个体；以及曾因精神疾病住院治疗≥1 年的个体。纳入研究的质量从中等至高不等。
目前的经济证据表明，并非所有包含 PAI 成分的多组分生活方式干预模式对精神分裂症或双相情感障碍患者都是具有成本效益的；并非所有精神分裂症或双相情感障碍患者都会从干预中平等受益。迫切需要开展未来研究以确定针对不同患者亚组的 PAI 的成本效益模式。
