000119654 001__ 119654 000119654 005__ 20230519145458.0 000119654 0247_ $$2doi$$a10.1186/s12966-021-01144-5 000119654 0248_ $$2sideral$$a126130 000119654 037__ $$aART-2021-126130 000119654 041__ $$aeng 000119654 100__ $$aAznar-Lou I. 000119654 245__ $$aCost-effectiveness analysis of a multiple health behaviour change intervention in people aged between 45 and 75 years: a cluster randomized controlled trial in primary care (EIRA study) 000119654 260__ $$c2021 000119654 5060_ $$aAccess copy available to the general public$$fUnrestricted 000119654 5203_ $$aBackground: Multiple health behaviour change (MHBC) interventions that promote healthy lifestyles may be an efficient approach in the prevention or treatment of chronic diseases in primary care. This study aims to evaluate the cost-utility and cost-effectiveness of the health promotion EIRA intervention in terms of MHBC and cardiovascular reduction. Methods: An economic evaluation alongside a 12-month cluster-randomised (1:1) controlled trial conducted between 2017 and 2018 in 25 primary healthcare centres from seven Spanish regions. The study took societal and healthcare provider perspectives. Patients included were between 45 and 75 years old and had any two of these three behaviours: smoking, insufficient physical activity or low adherence to Mediterranean dietary pattern. Intervention duration was 12 months and combined three action levels (individual, group and community). MHBC, defined as a change in at least two health risk behaviours, and cardiovascular risk (expressed in % points) were the outcomes used to calculate incremental cost-effectiveness ratios (ICER). Quality-adjusted life-years (QALYs) were estimated and used to calculate incremental cost-utility ratios (ICUR). Missing data was imputed and bootstrapping with 1000 replications was used to handle uncertainty in the modelling results. Results: The study included 3062 participants. Intervention costs were €295 higher than usual care costs. Five per-cent additional patients in the intervention group did a MHBC compared to usual care patients. Differences in QALYS or cardiovascular risk between-group were close to 0 (- 0.01 and 0.04 respectively). The ICER was €5598 per extra health behaviour change in one patient and €6926 per one-point reduction in cardiovascular risk from a societal perspective. The cost-utility analysis showed that the intervention increased costs and has no effect, in terms of QALYs, compared to usual care from a societal perspective. Cost-utility planes showed high uncertainty surrounding the ICUR. Sensitivity analysis showed results in line with the main analysis. Conclusion: The efficiency of EIRA intervention cannot be fully established and its recommendation should be conditioned by results on medium-long term effects. Trial registration: Clinicaltrials.gov NCT03136211. Registered 02 May 2017 – Retrospectively registered © 2021, The Author(s). 000119654 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII-MINECO/PI15/00114$$9info:eu-repo/grantAgreement/ES/ISCIII-MINECO/PI15/00519$$9info:eu-repo/grantAgreement/ES/MINECO/CP19-00029 000119654 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000119654 590__ $$a8.915$$b2021 000119654 591__ $$aPHYSIOLOGY$$b5 / 81 = 0.062$$c2021$$dQ1$$eT1 000119654 591__ $$aNUTRITION & DIETETICS$$b7 / 90 = 0.078$$c2021$$dQ1$$eT1 000119654 592__ $$a2.028$$b2021 000119654 593__ $$aNutrition and Dietetics$$c2021$$dQ1 000119654 593__ $$aMedicine (miscellaneous)$$c2021$$dQ1 000119654 594__ $$a10.2$$b2021 000119654 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000119654 700__ $$aZabaleta-Del-Olmo E. 000119654 700__ $$aCasajuana-Closas M. 000119654 700__ $$aSánchez-Viñas A. 000119654 700__ $$aParody-Rúa E. 000119654 700__ $$aBolíbar B. 000119654 700__ $$aIracheta-Todó M. 000119654 700__ $$aBulilete O. 000119654 700__ $$aLópez-Jiménez T. 000119654 700__ $$aPombo-Ramos H. 000119654 700__ $$aMartín Miguel M.V. 000119654 700__ $$0(orcid)0000-0002-5494-6550$$aMagallón-Botaya R.$$uUniversidad de Zaragoza 000119654 700__ $$aMaderuelo-Fernández J.Á. 000119654 700__ $$aMotrico E. 000119654 700__ $$aBellón J. 000119654 700__ $$aMartí-Lluch R. 000119654 700__ $$aRubio-Valera M. 000119654 700__ $$aSerrano-Blanco A. 000119654 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina 000119654 773__ $$g18, 1 (2021), 88 [15 pp]$$pInternational Journal of Behavioral Nutrition and Physical Activity$$tInternational Journal of Behavioral Nutrition and Physical Activity$$x1479-5868 000119654 8564_ $$s1050604$$uhttps://zaguan.unizar.es/record/119654/files/texto_completo.pdf$$yVersión publicada 000119654 8564_ $$s2092705$$uhttps://zaguan.unizar.es/record/119654/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000119654 909CO $$ooai:zaguan.unizar.es:119654$$particulos$$pdriver 000119654 951__ $$a2023-05-18-14:53:53 000119654 980__ $$aARTICLE