Cost-effectiveness of a motivational interviewing obesity intervention versus usual care in pediatric primary care offices.
Cost-effectiveness of a motivational interviewing obesity intervention versus usual care in pediatric primary care offices.
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DOI：
10.1002/oby.23560
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发表时间：
2022-11
期刊：
影响因子：
6.9
通讯作者：
Chang, Tammy
中科院分区：
文献类型：
--
作者：
Woolford, Susan J.;Resnicow, Kenneth;Davis, Matthew M.;Nichols, Lauren P.;Wasserman, Richard C.;Harris, Donna;Gebremariam, Achamyeleh;Shone, Laura;Fiks, Alexander G.;Chang, Tammy
本研究旨在评估2年动机访谈（MI）干预与常规初级保健的增量成本效益比（ICER）。在美国儿科学会的儿科研究办公室设置（PROS）网络中实施了一项国家试验，以评价MI与儿童常规护理（2 - 8岁;基线BMI 85 - 97分）。对医疗保健使用、食品成本、提供者费用和培训成本进行了评估，并进行了敏感性分析。主要结局是ICER，计算为干预与常规治疗的BMI百分位数每单位变化的成本。在2年时，72%的入组父母/子女二人组被保留; 312名儿童被纳入分析。干预组和对照组的平均BMI百分位数变化分别为-4.9和-1.8，导致BMI百分位数增量降低3.1（95% CI：1.2 - 5.0）。干预费用为每对1051美元（658美元用于培训DVD开发）。如果将医疗保健和非医疗保健成本进行比较，干预ICER为363美元（范围来自敏感性分析：成本节约，3159美元），每名参与者在2年内BMI百分位数下降。培训儿科医生、执业护士和注册营养师，在初级保健中为儿童肥胖提供基于MI的干预措施，具有临床有效性和可接受的成本效益。今后的工作应探讨更广泛地传播这一方法。
This study aimed to assess the incremental cost‐effectiveness ratio (ICER) of a 2‐year motivational interviewing (MI) intervention versus usual primary care. A national trial was implemented in the Pediatric Research in Office Settings (PROS) network of the American Academy of Pediatrics to evaluate MI versus usual care for children (2‐8 years old; baseline BMI 85th‐97th percentiles). Health care use, food costs, provider fees, and training costs were assessed, and sensitivity analyses were conducted. Primary outcome was the ICER, calculated as cost per unit change in BMI percentile for intervention versus usual care. At 2 years, 72% of enrolled parent/child dyads were retained; 312 children were included in the analysis. Mean BMI percentile point change was −4.9 and −1.8 for the intervention and control, respectively, yielding an incremental reduction of 3.1 BMI percentile points (95% CI: 1.2‐5.0). The intervention cost $1051 per dyad ($658 for training DVD development). Incorporating health care and non‐health care costs, the intervention ICER was $363 (range from sensitivity analyses: cost saving, $3159) per BMI percentile point decrease per participant over 2 years. Training pediatricians, nurse practitioners, and registered dietitians to deliver MI‐based interventions for childhood obesity in primary care is clinically effective and acceptably cost‐effective. Future work should explore this approach in broader dissemination.
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