Cost-effectiveness of physical activity counselling in general practice

Abstract

Aim: To assess the cost-effectiveness of the 'Green Prescription' physical activity counselling programme in general practice. Method: Prospective cost-effectiveness study undertaken as part of a cluster randomised controlled trial with 12-month follow-up of 878 'less-active' patients aged 40-79 years in 42 general practices in the Waikato. The intervention was verbal advice and a written exercise prescription given by general practitioners, with telephone exercise specialist follow-up compared with usual care. Main outcome measures included cost per total and leisure-time physical activity gain from health-funders' and societal perspectives. Results: Significant increases in physical activity were found in the randomised controlled trial. Programme-cost per patient was NZ$170 from a funder's perspective. The monthly cost-effectiveness ratio for total energy expenditure achieved was $11 per kcal/kg/day. The incremental cost of converting one additional 'sedentary' adult to an 'active' state over a twelve-month period was NZ$1,756 in programme costs. Conclusion: Verbal and written physical activity advice given in general practice with telephone follow-up is an inexpensive way of increasing activity for sedentary people, and has the potential to have significant economic impact through reduction in cardiovascular and other morbidity and mortality.