Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial

Broekhuizen, K; Simmons, D; Devlieger, R; van Assche, A; Jans, G; Galjaard, S; Corcoy, R; Adelantado, JM; Dunne, F; Desoye, G; Harreiter, J; Kautzky-Willer, A; Damm, P; Mathiesen, ER; Jensen, DM; Andersen, LL; Lapolla, A; Dalfra, MG; Bertolotto, A; Wender-Ozegowska, E; Zawiejska, A; Hill, D; Snoek, FJ; Jelsma, JGM; Bosmans, JE; van Poppel, MNM; van Dongen, JM

Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial

Background: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions f...

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Autores:	Broekhuizen, K, Simmons, D, Devlieger, R, van Assche, A, Jans, G, Galjaard, S, Corcoy, R, Adelantado, JM, Dunne, F, Desoye, G, Harreiter, J, Kautzky-Willer, A, Damm, P, Mathiesen, ER, Jensen, DM, Andersen, LL, Lapolla, A, Dalfra, MG, Bertolotto, A, Wender-Ozegowska, E, Zawiejska, A, Hill, D, Snoek, FJ, Jelsma, JGM, Bosmans, JE, van Poppel, MNM, van Dongen, JM
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2018
País:	España
Institución:	Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:	r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:	oai:iibsantpau.fundanetsuite.com:p3835
Acceso en línea:	https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3835
Access Level:	acceso abierto
Palabra clave:	Economic evaluation Cost-effectiveness Gestational diabetes Lifestyle intervention Pregnant women

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spelling	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trialBroekhuizen, KSimmons, DDevlieger, Rvan Assche, AJans, GGaljaard, SCorcoy, RAdelantado, JMDunne, FDesoye, GHarreiter, JKautzky-Willer, ADamm, PMathiesen, ERJensen, DMAndersen, LLLapolla, ADalfra, MGBertolotto, AWender-Ozegowska, EZawiejska, AHill, DSnoek, FJJelsma, JGMBosmans, JEvan Poppel, MNMvan Dongen, JMEconomic evaluationCost-effectivenessGestational diabetesLifestyle interventionPregnant womenBackground: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions for pregnant women at increased risk for GDM. The purpose of this study was to evaluate the cost-effectiveness of the healthy eating and/or physical activity promotion intervention compared to usual care among pregnant women at increased risk of GDM from a societal perspective. Methods: An economic evaluation was performed alongside a European multicenter-randomized controlled trial. A total of 435 pregnant women at increased risk of GDM in primary and secondary care settings in nine European countries, were recruited and randomly allocated to a healthy eating and physical activity promotion intervention (HE + PA intervention), a healthy eating promotion intervention (HE intervention), or a physical activity promotion intervention (PA intervention). Main outcome measures were gestational weight gain, fasting glucose, insulin resistance (HOMA-IR), quality adjusted life years (QALYs), and societal costs. Results: Between-group total cost and effect differences were not significant, besides significantly less gestational weight gain in the HE + PA group compared with the usual care group at 35-37 weeks (-2.3; 95% CI:-3.7;-0.9). Cost-effectiveness acceptability curves indicated that the HE + PA intervention was the preferred intervention strategy. At 35-37 weeks, it depends on the decision-makers' willingness to pay per kilogram reduction in gestational weight gain whether the HE + PA intervention is cost-effective for gestational weight gain, whereas it was not cost-effective for fasting glucose and HOMA-IR. After delivery, the HE + PA intervention was cost-effective for QALYs, which was predominantly caused by a large reduction in delivery-related costs. Conclusions: Healthy eating and physical activity promotion was found to be the preferred strategy for limiting gestational weight gain. As this intervention was cost-effective for QALYs after delivery, this study lends support for broad implementation.BMC2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3835International Journal of Behavioral Nutrition and Physical ActivityISSN: 14795868reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p38352026-06-14T12:41:47Z
dc.title.none.fl_str_mv	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial
title	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial
spellingShingle	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial Broekhuizen, K Economic evaluation Cost-effectiveness Gestational diabetes Lifestyle intervention Pregnant women
title_short	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial
title_full	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial
title_fullStr	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial
title_full_unstemmed	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial
title_sort	Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial
dc.creator.none.fl_str_mv	Broekhuizen, K Simmons, D Devlieger, R van Assche, A Jans, G Galjaard, S Corcoy, R Adelantado, JM Dunne, F Desoye, G Harreiter, J Kautzky-Willer, A Damm, P Mathiesen, ER Jensen, DM Andersen, LL Lapolla, A Dalfra, MG Bertolotto, A Wender-Ozegowska, E Zawiejska, A Hill, D Snoek, FJ Jelsma, JGM Bosmans, JE van Poppel, MNM van Dongen, JM
author	Broekhuizen, K
author_facet	Broekhuizen, K Simmons, D Devlieger, R van Assche, A Jans, G Galjaard, S Corcoy, R Adelantado, JM Dunne, F Desoye, G Harreiter, J Kautzky-Willer, A Damm, P Mathiesen, ER Jensen, DM Andersen, LL Lapolla, A Dalfra, MG Bertolotto, A Wender-Ozegowska, E Zawiejska, A Hill, D Snoek, FJ Jelsma, JGM Bosmans, JE van Poppel, MNM van Dongen, JM
author_role	author
author2	Simmons, D Devlieger, R van Assche, A Jans, G Galjaard, S Corcoy, R Adelantado, JM Dunne, F Desoye, G Harreiter, J Kautzky-Willer, A Damm, P Mathiesen, ER Jensen, DM Andersen, LL Lapolla, A Dalfra, MG Bertolotto, A Wender-Ozegowska, E Zawiejska, A Hill, D Snoek, FJ Jelsma, JGM Bosmans, JE van Poppel, MNM van Dongen, JM
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Economic evaluation Cost-effectiveness Gestational diabetes Lifestyle intervention Pregnant women
topic	Economic evaluation Cost-effectiveness Gestational diabetes Lifestyle intervention Pregnant women
description	Background: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions for pregnant women at increased risk for GDM. The purpose of this study was to evaluate the cost-effectiveness of the healthy eating and/or physical activity promotion intervention compared to usual care among pregnant women at increased risk of GDM from a societal perspective. Methods: An economic evaluation was performed alongside a European multicenter-randomized controlled trial. A total of 435 pregnant women at increased risk of GDM in primary and secondary care settings in nine European countries, were recruited and randomly allocated to a healthy eating and physical activity promotion intervention (HE + PA intervention), a healthy eating promotion intervention (HE intervention), or a physical activity promotion intervention (PA intervention). Main outcome measures were gestational weight gain, fasting glucose, insulin resistance (HOMA-IR), quality adjusted life years (QALYs), and societal costs. Results: Between-group total cost and effect differences were not significant, besides significantly less gestational weight gain in the HE + PA group compared with the usual care group at 35-37 weeks (-2.3; 95% CI:-3.7;-0.9). Cost-effectiveness acceptability curves indicated that the HE + PA intervention was the preferred intervention strategy. At 35-37 weeks, it depends on the decision-makers' willingness to pay per kilogram reduction in gestational weight gain whether the HE + PA intervention is cost-effective for gestational weight gain, whereas it was not cost-effective for fasting glucose and HOMA-IR. After delivery, the HE + PA intervention was cost-effective for QALYs, which was predominantly caused by a large reduction in delivery-related costs. Conclusions: Healthy eating and physical activity promotion was found to be the preferred strategy for limiting gestational weight gain. As this intervention was cost-effective for QALYs after delivery, this study lends support for broad implementation.
publishDate	2018
dc.date.none.fl_str_mv	2018
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3835
url	https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3835
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	BMC
publisher.none.fl_str_mv	BMC
dc.source.none.fl_str_mv	International Journal of Behavioral Nutrition and Physical Activity ISSN: 14795868 reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str	Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str	r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection	r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial

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