Evidence map›Paper›PMID 35325628›Full record

Trial reportThe Lancet. Public health2022

Cost-effectiveness of a physical activity and behaviour maintenance programme on functional mobility decline in older adults: an economic evaluation of the REACT (Retirement in Action) trial.

Tristan M Snowsill, Afroditi Stathi, Colin Green, Janet Withall, Colin J Greaves, Janice L Thompson, Gordon Taylor, Selena Gray, Heidi Johansen-Berg, James L J Bilzon and 8 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Lancet. Public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 3 pooled it
5.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 21 citations in OpenAlex.

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  19. SnacktivityHealthcare (Basel, Switzerland) · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 2 countries.

Tristan M SnowsillUniversity of Exeter Medical School, University of Exeter, Exeter, UK. Electronic address: t.m.snowsill@exeter.ac.uk.
Afroditi StathiSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Colin GreenUniversity of Exeter Medical School, University of Exeter, Exeter, UK.
Janet WithallSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK; Department for Health, University of Bath, Bath, UK.
Colin J GreavesSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Janice L ThompsonSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Gordon TaylorUniversity of Exeter Medical School, University of Exeter, Exeter, UK.
Selena GrayFaculty of Health and Applied Sciences, University of the West of England (UWE) Bristol, Bristol, UK.
Heidi Johansen-BergWellcome Centre for Integrative Neuroimaging, John Radcliffe Hospital, University of Oxford, Oxford, UK.
James L J BilzonDepartment for Health, University of Bath, Bath, UK.
Jolanthe L de KoningDepartment for Health, University of Bath, Bath, UK.
Jessica C BollenUniversity of Exeter Medical School, University of Exeter, Exeter, UK.
Sarah J MoorlockBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Max J WesternDepartment for Health, University of Bath, Bath, UK.
Jack M GuralnikDepartment of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
W Jack RejeskiDepartment of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
Kenneth R FoxCentre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
Antonieta Medina-LaraUniversity of Exeter Medical School, University of Exeter, Exeter, UK.
University of Exeter · GBUniversity of Bath · GBUniversity of Birmingham · GBUniversity of Bristol · GBUniversity of Maryland, Baltimore · USUniversity of the West of England · GBWake Forest University · USWellcome Centre for Integrative Neuroimaging · GB

Funding

Medical Research Council MR/P021220/1Wellcome TrustWellcome Trust 110027/Z/15/Z
6 · The paper itself

Abstract

backgroundMobility limitations in older populations have a substantial impact on health outcomes, quality of life, and social care costs. The Retirement in Action (REACT) randomised controlled trial assessed a 12-month community-based group physical activity and behaviour maintenance intervention to help prevent decline in physical functioning in older adults at increased risk of mobility limitation. We aimed to do an economic evaluation of the REACT trial to investigate whether the intervention is cost-effective.

methodsIn this health economic evaluation, we did cost-effectiveness and cost-utility analyses of the REACT programme versus standard care on the basis of resource use, primary outcome, and health-related quality-of-life data measured in the REACT trial. We also developed a decision analytic Markov model that forecasts the mobility of recipients beyond the 24-month follow-up of the trial and translated this into future costs and potential benefit to health-related quality of life using the National Health Service and Personal Social Services perspective. Participants completed questionnaire booklets at baseline, and at 6, 12, and 24 months after randomisation, which included a resource use questionnaire and the EQ-5D-5L and 36-item short-form survey (SF-36) health-related quality-of-life instruments. The cost of delivering the intervention was estimated by identifying key resources, such as REACT session leader time, time of an individual to coordinate the programme, and venue hire. EQ-5D-5L and SF-36 responses were converted to preference-based utility values, which were used to estimate quality-adjusted life-years (QALYs) over the 24-month trial follow-up using the area-under-the-curve method. We used generalised linear models to examine the effect of the REACT programme on costs and QALYs and adjust for baseline covariates. Costs and QALYs beyond 12 months were discounted at 3·5% per year. This is a pre-planned analysis of the REACT trial; the trial itself is registered with ISRCTN (ISRCTN45627165).

findingsThe 12-month REACT programme was estimated to cost £622 per recipient to deliver. The most substantial cost components are the REACT session leader time (£309 per participant), venue hire (£109), and the REACT coordinator time (£80). The base-case analysis of the trial-based economic evaluation showed that reductions in health and social care usage due to the REACT programme could offset the REACT delivery costs (£3943 in the intervention group vs £4043 in the control group; difference: -£103 [95% CI -£695 to £489]) with a health benefit of 0·04 QALYs (0·009-0·071; 1·354 QALYs in the intervention group vs 1·314 QALYs in the control group) within the 24-month timeframe of the trial.

interpretationThe REACT programme could be considered a cost-effective approach for improving the health-related quality of life of older adults at risk of mobility limitations.

fundingNational Institute for Health Research Public Health Research Programme.

Indexed as

Quality of LifeRetirementAgedCost-Benefit AnalysisExerciseHumansState Medicine

Identifiers

PMID35325628
PMCPMC8967720
OpenAlexW4220726560

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.