Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation
Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation
复制标题
DOI：
10.1007/s10549-010-1126-2
复制
发表时间：
2010-11-01
影响因子：
3.8
通讯作者：
Smith, Amanda
中科院分区：
文献类型：
--
作者：
Haines, Terry P.;Sinnamon, Patricia;Smith, Amanda
评估多媒体多模式体力活动计划对乳腺癌术后接受辅助治疗的女性的疗效和经济效益。我们进行了一项随机试验，同时进行增量成本效益分析和盲法基线，3，6和12个月的随访评估妇女接受辅助治疗乳腺癌手术后（n = 89）。干预是一个多媒体，多模式的运动计划，包括力量，平衡和耐力训练元素。对照是使用类似材料提供的假柔韧性和放松程序。主要结局是健康相关生活质量（EQ-5D和VAS，EORTC C30，BR 23）。经济成果包括直接保健费用和生产力的收益和损失。干预组受试者在基线和3个月评估之间的健康相关生活质量改善更大[平均（sd）EQ-5D VAS（0-100）基线：72.6（15.6），3个月：80.6（11.6）]与对照组参与者相比[基线：77.5（13.5），3个月：74.1（20.6），P = 0.006]，并且在身体功能方面改善更多[平均（sd）EORTC C30身体功能量表干预（0-100）基线：84.9（14.8），3个月：86.9（10.7），对照基线：91.3（9.6），3个月：86.7（14.9），P = 0.02]。这些改进在此之后就没有持续下去。干预组参与者的上肢体积也较低。然而，有低概率的干预将是更便宜和更有效的控制条件（范围概率= 0.05-50.02%，取决于方法）。提供多模式运动计划将改善接受乳腺癌辅助治疗的妇女的短期健康，但经济效益值得怀疑。
To evaluate the efficacy and economic efficiency of a multimedia, multimodal physical activity program for women undergoing adjuvant therapy following surgery for breast cancer. We conducted a randomized trial with concurrent incremental cost-effectiveness analysis and blinded baseline, 3, 6 and 12-month follow-up assessments amongst women undergoing adjuvant therapy following surgery for breast cancer (n = 89). The intervention was a multimedia, multimodal exercise program comprising strength, balance and endurance training elements. The control was sham flexibility and relaxation program delivered using similar materials. The primary outcome was health-related quality of life (EQ-5D & VAS, EORTC C30, BR23). Economic outcomes included direct health care costs and productivity gains and losses. Participants in the intervention group demonstrated greater improvement in health-related quality of life between baseline and the 3-month assessment [mean (sd) EQ-5D VAS (0-100) baseline: 72.6 (15.6), 3 month: 80.6 (11.6)] when compared to control group participants [baseline: 77.5 (13.5), 3 month: 74.1 (20.6), P = 0.006] and also improved more in terms of physical function [mean (sd) EORTC C30 physical function scale intervention (0-100) baseline: 84.9 (14.8), 3 month: 86.9 (10.7), control baseline: 91.3 (9.6), 3 month: 86.7 (14.9), P = 0.02]. These improvements were not sustained beyond this point. Upper limb volumes were also lower amongst intervention group participants. However, there was low probability that the intervention would be both less costly and more effective than the control condition (range probability = 0.05-50.02% depending on approach). Provision of multimodal exercise programs will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of questionable economic efficiency.