Cost-effectiveness of Exercise-based Rehabilitation Program
Conditions
Keywords
Acute coronary syndrome, Cost-effectiveness, Cardiac rehabilitation, Exercise, Physical activity, Home monitoring
Brief summary
The objective of this multidisciplinary study is to employ health-economic evaluation in determining the health benefits achieved with exercise-based cardiac rehabilitation and the costs derived from it compared with conventional post-acute care of cardiac patients in the Finnish health care system.
Detailed description
The cost-effectiveness of exercise-based cardiac rehabilitation has not been systematically studied earlier in Finland, and it is not justifiable to directly apply the results of studies done in other countries to circumstances in Finland due to differences in the health care and social security systems between the countries. The research will utilize top Finnish expertise spanning clinical cardiology, health economics, and physical education. The hypothesis is that a quality-adjusted life year of a cardiac patient (cost/QALY) is 20 % less costly in a rehabilitation group than in a conventional post-acute care group. The participants in the study will be recruited from Oulu University Hospital patients from the Oulu region (n = 300) who have suffered acute coronary syndrome (angiographically diagnosed coronary artery disease). Of these patients, 130 will be randomized to exercise-based cardiac rehabilitation (Verve) and 170 to a control group. Dropping out of the intervention will be mini-mized by means of careful definition of the inclusion criteria and close follow-up. The rehabilitation will seek to implement the most recent international recommendations for health-enhancing physical activity (% of those who achieved the exercise target). Instructions for a progressive training model will be compiled. The amount of exercise will be monitored objectively with a wrist-worn device based on wellness technology. Subjective loading of both the training and health-enhancing physical activity will be monitored using self-evaluation. The study will last one year for each patient, after which cost-effectiveness will be analyzed (University of Eastern Finland). The results of the research will facilitate decision making and choices in Finnish health care when arranging rehabilitation for cardiac patients and planning the optimal utilization of health care resources.
Interventions
BEHAVIORALExercise based cardiac rehabilitation
The cost-effectiveness between the exercise training vs. control groups
Sponsors
Verve Research, Oulu, Finland
University of Eastern Finland
Oulu University Hospital
University of Oulu
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* The patients undergo coronary angiography and are diagnosed with coronary artery disease.
Exclusion criteria
* New York Heart Association (NYHA) class IV * heart failure * unstable chest pain (angina pectoris) at the time of randomization * severe peripheral atherosclerosis (intermittent claudication) * severe retinopathy or neuropathy related to diabetes.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cost / quality-adjusted life year of a cardiac patient (QALY) | One year / patient |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Major Adverse Cardiac Event (MACE) | One year / patient | significant clinical adverse events, overall mortality, and acute cardiac arrest or resuscitation from cardiac arrest. |
Countries
Finland
Contacts
Primary ContactTimo H Mäkikallio, MD
Outcome results
None listed