Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the dali study, a european multicenter randomized controlled trial
View/ Open
Full Text
Date
2018-03-14Author
Broekhuizen, Karen
Simmons, David
Devlieger, Roland
van Assche, André
Jans, Goele
Galjaard, Sander
Corcoy, Rosa
Adelantado, Juan M.
Dunne, Fidelma
Desoye, Gernot
Harreiter, Jürgen
Kautzky-Willer, Alexandra
Damm, Peter
Mathiesen, Elisabeth R.
Jensen, Dorte M.
Andersen, Liselotte L.
Lapolla, Annunziata
Dalfra, Maria G.
Bertolotto, Alessandra
Wender-Ozegowska, Ewa
Zawiejska, Agnieszka
Hill, David
Snoek, Frank J.
Jelsma, Judith G. M.
Bosmans, Judith E.
van Poppel, Mireille N. M.
van Dongen, Johanna M.
Metadata
Show full item recordUsage
This item's downloads: 0 (view details)
Cited 10 times in Scopus (view citations)
Recommended Citation
Broekhuizen, Karen; Simmons, David; Devlieger, Roland; van Assche, André; Jans, Goele; Galjaard, Sander; Corcoy, Rosa; Adelantado, Juan M. Dunne, Fidelma; Desoye, Gernot; Harreiter, Jürgen; Kautzky-Willer, Alexandra; Damm, Peter; Mathiesen, Elisabeth R.; Jensen, Dorte M.; Andersen, Liselotte L.; Lapolla, Annunziata; Dalfra, Maria G.; Bertolotto, Alessandra; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Hill, David; Snoek, Frank J.; Jelsma, Judith G. M.; Bosmans, Judith E.; van Poppel, Mireille N. M.; van Dongen, Johanna M. (2018). Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the dali study, a european multicenter randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity 15 ,
Published Version
Abstract
Background: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions for pregnant women at increased risk for GDM. The purpose of this study was to evaluate the cost-effectiveness of the healthy eating and/or physical activity promotion intervention compared to usual care among pregnant women at increased risk of GDM from a societal perspective.
Methods: An economic evaluation was performed alongside a European multicenter-randomized controlled trial. A total of 435 pregnant women at increased risk of GDM in primary and secondary care settings in nine European countries, were recruited and randomly allocated to a healthy eating and physical activity promotion intervention (HE + PA intervention), a healthy eating promotion intervention (HE intervention), or a physical activity promotion intervention (PA intervention). Main outcome measures were gestational weight gain, fasting glucose, insulin resistance (HOMA-IR), quality adjusted life years (QALYs), and societal costs.
Results: Between-group total cost and effect differences were not significant, besides significantly less gestational weight gain in the HE + PA group compared with the usual care group at 35-37 weeks (-2.3; 95% CI:-3.7;-0.9). Cost-effectiveness acceptability curves indicated that the HE + PA intervention was the preferred intervention strategy. At 35-37 weeks, it depends on the decision-makers' willingness to pay per kilogram reduction in gestational weight gain whether the HE + PA intervention is cost-effective for gestational weight gain, whereas it was not cost-effective for fasting glucose and HOMA-IR. After delivery, the HE + PA intervention was cost-effective for QALYs, which was predominantly caused by a large reduction in delivery-related costs.
Conclusions: Healthy eating and physical activity promotion was found to be the preferred strategy for limiting gestational weight gain. As this intervention was cost-effective for QALYs after delivery, this study lends support for broad implementation.