Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Mar;61(584):e125-33.
doi: 10.3399/bjgp11X561249.

Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence

Sue Garrett  1 , C Raina Elley, Sally B Rose, Des O'Dea, Beverley A Lawton, Anthony C Dowell
Affiliations

Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence

Sue Garrett et al. Br J Gen Pract. 2011 Mar.

Abstract

Background: The health and economic burden of physical inactivity is well documented. A wide range of primary care and community-based interventions are available to increase physical activity. It is important to identify which components of these interventions provide the best value for money.

Aim: To assess the cost-effectiveness of physical activity interventions in primary care and the community.

Design of study: Systematic review of cost-effectiveness studies based on randomised controlled trials of interventions to increase adult physical activity that were based in primary health care or the community, completed between 2002 and 2009.

Method: Electronic databases were searched to identify relevant literature. Results and study quality were assessed by two researchers, using Drummond's checklist for economic evaluations. Cost-effectiveness ratios for moving one person from inactive to active, and cost-utility ratios (cost per quality-adjusted life-year [QALY]) were compared between interventions.

Results: Thirteen studies fulfilled the inclusion criteria. Eight studies were of good or excellent quality. Interventions, study populations, and study designs were heterogeneous, making comparisons difficult. The cost to move one person to the 'active' category at 12 months was estimated for four interventions ranging from €331 to €3673. The cost-utility was estimated in nine studies, and varied from €348 to €86,877 per QALY.

Conclusion: Most interventions to increase physical activity were cost-effective, especially where direct supervision or instruction was not required. Walking, exercise groups, or brief exercise advice on prescription delivered in person, or by phone or mail appeared to be more cost-effective than supervised gym-based exercise classes or instructor-led walking programmes. Many physical activity interventions had similar cost-utility estimates to funded pharmaceutical interventions and should be considered for funding at a similar level.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Cost-utility (cost per QALY) for different physical activity interventions (2008 equivalent €).
See this image and copyright information in PMC

References

    1. Oldridge NB. Economic burden of physical inactivity: healthcare costs associated with cardiovascular disease. Eur J Cardiovasc Prev Rehabil. 2008;15(2):130–139. - PubMed
    1. Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med. 2002;22(4 suppl):73–107. - PubMed
    1. US Preventive Services Task Force. Behavioral counseling in primary care to promote physical activity: recommendation and rationale. Ann Intern Med. 2002;137(3):205–207. - PubMed
    1. Stevens W, Hillsdon M, Thorogood M, McArdle D. Cost-effectiveness of a primary care based physical activity intervention in 45–74 year old men and women: a randomised controlled trial. Br J Sports Med. 1998;32(3):236–241. - PMC - PubMed
    1. Ministry of Health. A portrait of health: key results of the 2006/07 New Zealand Health Survey. Wellington: Ministry of Health; 2008.

Publication types