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Cost-utility analysis of a randomized controlled weight loss trial among lactating overweight/obese women

Journal article
Authors Lars A Hagberg
Hilde Kristin Brekke
Fredrik Bertz
Anna Winkvist
Published in BMC Public Health
Volume 15
Issue 1
ISSN 1471-2458
Publication year 2014
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Language en
Links dx.doi.org/10.1186/1471-2458-14-38
https://gup.ub.gu.se/file/127404
Subject categories Clinical Medicine

Abstract

Abstract Background Overweight and obesity among young, adult women are increasing problems in Sweden as in many other countries. The postpartum period may be a good opportunity to improve eating habits and lose weight in a sustainable manner. The aim was to make a cost-utility analysis of a dietary behavior modification treatment alongside usual care, compared to usual care alone, among lactating overweight and obese women. Methods This study was a cost-utility analysis based on a randomized controlled and longitudinal clinical diet intervention. Between 2007-2010, 68 women living in Sweden were, after baseline measurement at 8-12 weeks postpartum, randomly assigned to a 12-week dietary behavior modification treatment or control group. Inclusion criteria were: self-reported pre-pregnancy body mass index (BMI) 25-35 kg/m2, non-smoker, singleton term delivery, birth weight > 2500 g, intention to breastfeed for 6 mo and no diseases (mother and child). The women in the intervention group received 1.5 hour of individual counseling at study start and 1 hour at follow-up home visits after 6 weeks of intervention, with support through cell phone text messages every two wk. Dietary intervention aimed to reduce dietary intake by 500 kcal/day. The control group received usual care. Weight results have previously been reported. Here we report on analyses carried out during 2012-2013 of cost per quality adjusted life years (QALY), based on the changes in quality of life measured by EQ-5D-3 L and SF-6D. Likelihood of cost-effectiveness was calculated using Net Monetary Benefit method. Results Based on conservative assumptions of no remaining effect after 1 year follow-up, the diet intervention was cost-effective. Costs per gained QALY were 8 643 – 9 758 USD. The likelihood for cost-effectiveness, considering a willingness to pay 50 000 USD for a QALY, was 87–93%. Conclusions The diet intervention is cost-effective. Trial registration ClinicalTrials.gov Identifier: NCT01343238 Registered April 27, 2011. The regional ethics committee in Gothenburg, Sweden, approved the study on November 15, 2006.

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