BACKGROUND: Diabetes is a highly prevalent and costly disease. Studies indicate that combined diet and physical activity promotion programs can prevent type 2 diabetes among persons at increased risk. PURPOSE: To systematically evaluate the evidence on cost, cost-effectiveness, and cost-benefit estimates of diet and physical activity promotion programs. DATA SOURCES: Cochrane Library, EMBASE, MEDLINE, PsycINFO, Sociological Abstracts, Web of Science, EconLit, and CINAHL through 7 April 2015. STUDY SELECTION: English-language studies from high-income countries that provided data on cost, cost-effectiveness, or cost-benefit ratios of diet and physical activity promotion programs with at least 2 sessions over at least 3 months delivered to persons at increased risk for type 2 diabetes. DATA EXTRACTION: Dual abstraction and assessment of relevant study details. DATA SYNTHESIS: Twenty-eight studies were included. Costs were expressed in 2013 U.S. dollars. The median program cost per participant was $653. Costs were lower for group-based programs (median, $417) and programs implemented in community or primary care settings (median, $424) than for the U.S. DPP (Diabetes Prevention Program) trial and the DPP Outcomes Study ($5881). Twenty-two studies assessed the incremental cost-effectiveness ratios (ICERs) of the programs. From a health system perspective, 16 studies reported a median ICER of $13 761 per quality-adjusted life-year (QALY) saved. Group-based programs were more cost-effective (median, $1819 per QALY) than those that used individual sessions (median, $15 846 per QALY). No cost-benefit studies were identified. LIMITATION: Information on recruitment costs and cost-effectiveness of translational programs implemented in community and primary care settings was limited. CONCLUSION: Diet and physical activity promotion programs to prevent type 2 diabetes are cost-effective among persons at increased risk. Costs are lower when programs are delivered to groups in community or primary care settings. PRIMARY FUNDING SOURCE: None.
BACKGROUND:Diabetes is a highly prevalent and costly disease. Studies indicate that combined diet and physical activity promotion programs can prevent type 2 diabetes among persons at increased risk. PURPOSE: To systematically evaluate the evidence on cost, cost-effectiveness, and cost-benefit estimates of diet and physical activity promotion programs. DATA SOURCES: Cochrane Library, EMBASE, MEDLINE, PsycINFO, Sociological Abstracts, Web of Science, EconLit, and CINAHL through 7 April 2015. STUDY SELECTION: English-language studies from high-income countries that provided data on cost, cost-effectiveness, or cost-benefit ratios of diet and physical activity promotion programs with at least 2 sessions over at least 3 months delivered to persons at increased risk for type 2 diabetes. DATA EXTRACTION: Dual abstraction and assessment of relevant study details. DATA SYNTHESIS: Twenty-eight studies were included. Costs were expressed in 2013 U.S. dollars. The median program cost per participant was $653. Costs were lower for group-based programs (median, $417) and programs implemented in community or primary care settings (median, $424) than for the U.S. DPP (Diabetes Prevention Program) trial and the DPP Outcomes Study ($5881). Twenty-two studies assessed the incremental cost-effectiveness ratios (ICERs) of the programs. From a health system perspective, 16 studies reported a median ICER of $13 761 per quality-adjusted life-year (QALY) saved. Group-based programs were more cost-effective (median, $1819 per QALY) than those that used individual sessions (median, $15 846 per QALY). No cost-benefit studies were identified. LIMITATION: Information on recruitment costs and cost-effectiveness of translational programs implemented in community and primary care settings was limited. CONCLUSION: Diet and physical activity promotion programs to prevent type 2 diabetes are cost-effective among persons at increased risk. Costs are lower when programs are delivered to groups in community or primary care settings. PRIMARY FUNDING SOURCE: None.
Authors: Ira S Ockene; Trinidad L Tellez; Milagros C Rosal; George W Reed; John Mordes; Philip A Merriam; Barbara C Olendzki; Garry Handelman; Robert Nicolosi; Yunsheng Ma Journal: Am J Public Health Date: 2011-12-15 Impact factor: 9.308
Authors: X R Pan; G W Li; Y H Hu; J X Wang; W Y Yang; Z X An; Z X Hu; J Lin; J Z Xiao; H B Cao; P A Liu; X G Jiang; Y Y Jiang; J P Wang; H Zheng; H Zhang; P H Bennett; B V Howard Journal: Diabetes Care Date: 1997-04 Impact factor: 19.112
Authors: M Kaye Kramer; Andrea M Kriska; Elizabeth M Venditti; Rachel G Miller; Maria M Brooks; Lora E Burke; Linda M Siminerio; Francis X Solano; Trevor J Orchard Journal: Am J Prev Med Date: 2009-12 Impact factor: 5.043
Authors: Thomas J Hoerger; Katherine A Hicks; Stephen W Sorensen; William H Herman; Robert E Ratner; Ronald T Ackermann; Ping Zhang; Michael M Engelgau Journal: Diabetes Care Date: 2007-08-13 Impact factor: 19.112
Authors: Elizabeth C Rhodes; Eeshwar K Chandrasekar; Shivani A Patel; K M Venkat Narayan; Thomas V Joshua; Lovoria B Williams; Lucy Marion; Mohammed K Ali Journal: Diabetes Res Clin Pract Date: 2018-09-28 Impact factor: 5.602
Authors: Mohammed K Ali; Frank Wharam; O Kenrik Duru; Julie Schmittdiel; Ronald T Ackermann; Jeanine Albu; Dennis Ross-Degnan; Christine M Hunter; Carol Mangione; Edward W Gregg Journal: Curr Diab Rep Date: 2018-11-20 Impact factor: 4.810
Authors: J Sonya Haw; Karla I Galaviz; Audrey N Straus; Alysse J Kowalski; Matthew J Magee; Mary Beth Weber; Jingkai Wei; K M Venkat Narayan; Mohammed K Ali Journal: JAMA Intern Med Date: 2017-12-01 Impact factor: 21.873