Cargando…

Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

OBJECTIVE: The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with...

Descripción completa

Detalles Bibliográficos
Autores principales: Rushing, J., Wing, R., Wadden, T. A., Knowler, W. C., Lawlor, M., Evans, M., Killean, T., Montez, M., Espeland, M. A., Zhang, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358076/
https://www.ncbi.nlm.nih.gov/pubmed/28392928
http://dx.doi.org/10.1002/osp4.92
_version_ 1782516163266215936
author Rushing, J.
Wing, R.
Wadden, T. A.
Knowler, W. C.
Lawlor, M.
Evans, M.
Killean, T.
Montez, M.
Espeland, M. A.
Zhang, P.
author_facet Rushing, J.
Wing, R.
Wadden, T. A.
Knowler, W. C.
Lawlor, M.
Evans, M.
Killean, T.
Montez, M.
Espeland, M. A.
Zhang, P.
author_sort Rushing, J.
collection PubMed
description OBJECTIVE: The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. METHODS: The ILI was designed to promote weight loss and increase physical activity. It involved a combination of group plus individual intervention sessions, with decreasing frequency of contact over the 10 years. The intervention incorporated a variety of strategies, including meal replacement products, to improve weight loss outcomes. The costs of intervention delivery were derived from staff surveys of effort and from records of intervention materials from the 16 US academic clinical trial sites. Costs were calculated from the payer perspective and presented in 2012 dollars. RESULTS: During the first year, when intervention delivery was most intensive, the annual cost of intervention delivery, averaged (standard deviation) across clinical sites, was $2,864.6 ($513.3) per ILI participant compared with $202.4 ($76.6) per DSE participant. As intervention intensity declined, costs decreased, such that from years 5 to 9 of the trial, the annual cost of intervention was $1,119.8 ($227.7) per ILI participant and $102.9 ($33.0) per DSE participant. Staffing accounted for the majority of costs throughout the trial, with meal replacements and materials to promote adherence accounting for smaller shares. CONCLUSIONS: The sustained weight losses produced by the Look AHEAD intervention were supported by intervention costs that were within the range of other weight loss programmes. Future work will include an evaluation of the cost‐effectiveness of the ILI and will contain additional follow‐up data.
format Online
Article
Text
id pubmed-5358076
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-53580762017-04-06 Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial Rushing, J. Wing, R. Wadden, T. A. Knowler, W. C. Lawlor, M. Evans, M. Killean, T. Montez, M. Espeland, M. A. Zhang, P. Obes Sci Pract Original Articles OBJECTIVE: The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. METHODS: The ILI was designed to promote weight loss and increase physical activity. It involved a combination of group plus individual intervention sessions, with decreasing frequency of contact over the 10 years. The intervention incorporated a variety of strategies, including meal replacement products, to improve weight loss outcomes. The costs of intervention delivery were derived from staff surveys of effort and from records of intervention materials from the 16 US academic clinical trial sites. Costs were calculated from the payer perspective and presented in 2012 dollars. RESULTS: During the first year, when intervention delivery was most intensive, the annual cost of intervention delivery, averaged (standard deviation) across clinical sites, was $2,864.6 ($513.3) per ILI participant compared with $202.4 ($76.6) per DSE participant. As intervention intensity declined, costs decreased, such that from years 5 to 9 of the trial, the annual cost of intervention was $1,119.8 ($227.7) per ILI participant and $102.9 ($33.0) per DSE participant. Staffing accounted for the majority of costs throughout the trial, with meal replacements and materials to promote adherence accounting for smaller shares. CONCLUSIONS: The sustained weight losses produced by the Look AHEAD intervention were supported by intervention costs that were within the range of other weight loss programmes. Future work will include an evaluation of the cost‐effectiveness of the ILI and will contain additional follow‐up data. John Wiley and Sons Inc. 2017-02-24 /pmc/articles/PMC5358076/ /pubmed/28392928 http://dx.doi.org/10.1002/osp4.92 Text en © 2016 The Authors. Obesity Science & Practice published by John Wiley & Sons Ltd, World Obesity and The Obesity Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Rushing, J.
Wing, R.
Wadden, T. A.
Knowler, W. C.
Lawlor, M.
Evans, M.
Killean, T.
Montez, M.
Espeland, M. A.
Zhang, P.
Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial
title Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial
title_full Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial
title_fullStr Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial
title_full_unstemmed Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial
title_short Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial
title_sort cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the look ahead clinical trial
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358076/
https://www.ncbi.nlm.nih.gov/pubmed/28392928
http://dx.doi.org/10.1002/osp4.92
work_keys_str_mv AT rushingj costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT wingr costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT waddenta costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT knowlerwc costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT lawlorm costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT evansm costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT killeant costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT montezm costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT espelandma costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT zhangp costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial
AT costofinterventiondeliveryinalifestyleweightlosstrialintype2diabetesresultsfromthelookaheadclinicaltrial