The cost-effectiveness of a cardiovascular risk reduction program in general practice

Area of Science:

• Cardiovascular Disease Prevention
• Health Economics
• General Practice Interventions

Background:

• Cardiovascular disease (CVD) poses a significant public health challenge.
• Lifestyle modification is crucial for managing CVD risk factors.
• General practice settings offer opportunities for delivering lifestyle interventions.

Purpose of the Study:

• To evaluate the cost-effectiveness of general practice-based lifestyle change programs for patients at risk of CVD.
• To compare the effectiveness of two lifestyle interventions against routine care.

Main Methods:

• A randomized controlled trial was conducted alongside an economic evaluation.
• Interventions included educational materials and videos for General Practitioners (GPs) and patients.
• Patients were randomized into routine care, video intervention, or video + self-help groups.
• Outcomes measured included changes in blood pressure, body mass index, cholesterol, and smoking status over 1 year.

Main Results:

• Lifestyle interventions showed no significant improvement in cardiovascular risk factors compared to routine care.
• The cost per Quality Adjusted Life Year (QALY) for males ranged from $AUD152,000 to $AUD204,000.
• Targeting high-risk males suggested a cost of approximately $AUD30,000 per QALY.

Conclusions:

• There is insufficient evidence to support the effectiveness of general practice-based lifestyle programs.
• Resources may be more effectively utilized by focusing on high-risk patients actively considering behavioral changes.