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Bailly L, Mossé P, Diagana S, Fournier M, d'Arripe-Longueville F, Diagana O, Gal J, Grebet J, Moncada M, Domerego JJ, Radel R, Fabre R, Fuch A, Pradier C. "As du Coeur" study: a randomized controlled trial on quality of life impact and cost effectiveness of a physical activity program in patients with cardiovascular disease. BMC Cardiovasc Disord 2018; 18:225. [PMID: 30522438 PMCID: PMC6284296 DOI: 10.1186/s12872-018-0973-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 11/28/2018] [Indexed: 12/30/2022] Open
Abstract
Background Physical activity programs (PAP) in patients with cardiovascular disease require evidence of cost-utility. To assess improvement in health-related quality of life (QoL) and reduction of health care consumption of patients following PAP, a randomized trial was used. Methods Patients from a health insurance company who had experienced coronary artery disease or moderate heart failure were invited to participate (N = 1891). Positive responders (N = 50) were randomly assigned to a progressively autonomous physical activity (PAPA) program or to a standard supervised physical activity (SPA) program. The SPA group had two supervised sessions per week over 5 months. PAPA group had one session per week and support to aid habit formation (written tips, exercise program, phone call). To measure health-related quality of life EQ-5D utility score were used, before intervention, 6 months (T6) and 1 year later. Health care costs were provided from reimbursement databases. Results Mobility, usual activities and discomfort improved significantly in both group (T6). One year later, EQ-5D utility score was improved in the PAPA group only. Total health care consumption in the intervention group decreased, from a mean of 4097 euros per year before intervention to 2877 euros per year after (p = 0.05), compared to a health care consumption of 4087 euros and 4180 euros per year, in the total population of patients (N = 1891) from the health insurance company. The incremental cost effectiveness ratio was 10,928 euros per QALYs. Conclusion A physical activity program is cost-effective in providing a better quality of life and reducing health care consumption in cardiovascular patients. Trial registration ISRCTN77313697, retrospectively registered on 20 November 2015. Electronic supplementary material The online version of this article (10.1186/s12872-018-0973-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laurent Bailly
- Département de Santé Publique, Centre Hospitalier Universitaire de Nice (Public Health Department University Hospital of Nice), F-06202, Nice, France. .,Université Côte d'Azur, LAMHESS, Nice, France. .,Département de Santé Publique, CHU Nice, Hôpital Archet 1. Niveau1 151 Route Saint Antoine de Ginestière CS 23079, 06202, Nice Cedex 3, France.
| | - Philippe Mossé
- LEST, Aix-Marseille Université, CNRS, Aix en Provence, France
| | | | | | | | - Odile Diagana
- Diagana Sport Santé, Nice, France.,Azur Sport Santé, Nice, France
| | - Jocelyn Gal
- Epidemiology and Biostatistics Unit, Centre Antoine Lacassagne, Nice, France
| | - Jean Grebet
- Sécurité Sociale des Indépendants, Nice, France
| | | | | | - Rémi Radel
- Université Côte d'Azur, LAMHESS, Nice, France
| | - Roxane Fabre
- Département de Santé Publique, Centre Hospitalier Universitaire de Nice (Public Health Department University Hospital of Nice), F-06202, Nice, France.,EA Cobtek, University of Nice Sophia-Antipolis, Nice, France
| | - Alain Fuch
- Azur Sport Santé, Nice, France.,Sécurité Sociale des Indépendants, Nice, France
| | - Christian Pradier
- Département de Santé Publique, Centre Hospitalier Universitaire de Nice (Public Health Department University Hospital of Nice), F-06202, Nice, France.,Université Côte d'Azur, LAMHESS, Nice, France
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Abstract
Rubella and varicella zoster virus (VZV) infections during pregnancy can cause severe adverse outcomes in the embryo or foetus. Despite the availability of safe and efficacious vaccines, cases of congenital rubella and varicella syndrome still occur in Europe. As of 2004, several countries had high proportions of women of childbearing age that were susceptible to rubella and varicella virus infection. Effective immunisation strategies to enhance prevention should include an active role of different medical specialists in order to include all medical consultations a person may have at different points in their lives as an opportunity to immunise susceptibles. Linkage of data on infectious diseases with those from congenital defects registries may be helpful to monitor the epidemiology of congenital rubella and varicella.
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Affiliation(s)
- E Pandolfi
- Paediatric Hospital Bambino Gesù, Rome, Italy
| | - G Chiaradia
- Catholic University, Hygiene Institute, Rome, Italy
| | - M Moncada
- Paediatric Hospital Bambino Gesù, Rome, Italy
| | - L Rava
- Paediatric Hospital Bambino Gesù, Rome, Italy
| | - A E Tozzi
- Paediatric Hospital Bambino Gesù, Rome, Italy
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