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Are Office-Based Workplace Interventions Designed to Reduce Sitting Time Cost-Effective Primary Prevention Measures for Cardiovascular Disease? A Systematic Review and Modelled Economic Evaluation

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  • Lan Gao

    (Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC 3127, Australia
    Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, VIC 3127, Australia
    School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan NSW 2308, Australia)

  • Phuong Nguyen

    (Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC 3127, Australia
    Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, VIC 3127, Australia)

  • David Dunstan

    (Baker Heart and Diabetes Institute, Melbourne 3004, Australia
    School of Public Health, The University of Queensland, Brisbane 4072, Australia
    School of Sport Science, Exercise & Health, University of Western Australia, Perth 6907, Australia
    School of Exercise and Nutrition Sciences, Deakin University, Melbourne 3125, Australia)

  • Marjory Moodie

    (Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC 3127, Australia
    Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, VIC 3127, Australia)

Abstract

Objectives: To assess the cost-effectiveness of workplace-delivered interventions designed to reduce sitting time as primary prevention measures for cardiovascular disease (CVD) in Australia. Methods: A Markov model was developed to simulate the lifetime cost-effectiveness of a workplace intervention for the primary prevention of CVD amongst office-based workers. An updated systematic review and a meta-analysis of workplace interventions that aim to reduce sitting time was conducted to inform the intervention effect. The primary outcome was workplace standing time. An incremental cost-effectiveness ratio (ICER) was calculated for this intervention measured against current practice. Costs (in Australia dollars) and benefits were discounted at 3% annually. Both deterministic (DSA) and probabilistic (PSA) sensitivity analyses were performed. Results: The updated systematic review identified only one new study. Only the multicomponent intervention that included a sit-and-stand workstation showed statistically significant changes in the standing time compared to the control. The intervention was associated with both higher costs ($6820 versus $6524) and benefits (23.28 versus 23.27, quality-adjusted life year, QALYs), generating an ICER of $43,825/QALY. The DSA showed that target age group for the intervention, relative risk of CVD relative to the control and intervention cost were the key determinants of the ICER. The base case results were within the range of the 95% confidence interval and the intervention had a 85.2% probability of being cost-effective. Conclusions: A workplace-delivered intervention in the office-based setting including a sit-and-stand desk component is a cost-effective strategy for the primary prevention of CVD. It offers a new option and location when considering interventions to target the growing CVD burden.

Suggested Citation

  • Lan Gao & Phuong Nguyen & David Dunstan & Marjory Moodie, 2019. "Are Office-Based Workplace Interventions Designed to Reduce Sitting Time Cost-Effective Primary Prevention Measures for Cardiovascular Disease? A Systematic Review and Modelled Economic Evaluation," IJERPH, MDPI, vol. 16(5), pages 1-17, March.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:5:p:834-:d:211876
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    References listed on IDEAS

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    1. Linda J Cobiac & Theo Vos & Jan J Barendregt, 2009. "Cost-Effectiveness of Interventions to Promote Physical Activity: A Modelling Study," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-11, July.
    2. Linda J Cobiac & Anne Magnus & Stephen Lim & Jan J Barendregt & Rob Carter & Theo Vos, 2012. "Which Interventions Offer Best Value for Money in Primary Prevention of Cardiovascular Disease?," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-10, July.
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    1. Bradley MacDonald & Ann-Marie Gibson & Xanne Janssen & Jasmin Hutchinson & Samuel Headley & Tracey Matthews & Alison Kirk, 2019. "Should We Scale-Up? A Mixed Methods Process Evaluation of an Intervention Targeting Sedentary Office Workers Using the RE-AIM QuEST Framework," IJERPH, MDPI, vol. 17(1), pages 1-18, December.
    2. Edward Cox & Simon Walker & Charlotte L. Edwardson & Stuart J. H. Biddle & Alexandra M. Clarke-Cornwell & Stacy A. Clemes & Melanie J. Davies & David W. Dunstan & Helen Eborall & Malcolm H. Granat & L, 2022. "The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time," IJERPH, MDPI, vol. 19(22), pages 1-14, November.
    3. Fehmidah Munir & Paul Miller & Stuart J.H. Biddle & Melanie J. Davies & David W. Dunstan & Dale W. Esliger & Laura J. Gray & Sophie E. O’Connell & Ghazala Waheed & Thomas Yates & Charlotte L. Edwardso, 2020. "A Cost and Cost-Benefit Analysis of the Stand More AT Work (SMArT Work) Intervention," IJERPH, MDPI, vol. 17(4), pages 1-9, February.

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