TY - JOUR
T1 - Value of Implementation of Strategies to Increase the Adherence of Health Professionals and Cancer Survivors to Guideline-Based Physical Exercise
AU - Mewes, Janne C.
AU - Steuten, Lotte M.G.
AU - IJsbrandy, Charlotte
AU - IJzerman, Maarten J.
AU - van Harten, Willem H.
PY - 2017/12
Y1 - 2017/12
N2 - Background: To increase the adherence of health professionals and cancer survivors to evidence-based physical exercise, effective implementation strategies (ISTs) are required. Objectives: To examine to what extent these ISTs provide value for money and which IST has the highest expected value. Methods: The net benefit framework of health economic evaluations is used to conduct a value-of-implementation analysis of nine ISTs. Seven are directed to health professionals and two to cancer survivors. The analysis consists of four steps: 1) analyzing the expected value of perfect implementation (EVPIM); 2) assessing the estimated costs of the various ISTs; 3) comparing the ISTs' costs with the EVPIM; and 4) assessing the total net benefit (TNB) of the ISTs. These steps are followed to identify which strategy has the greatest value. Results: The EVPIM for physical exercise in the Netherlands is €293 million. The total costs for the ISTs range from €34,000 for printed educational materials for professionals to €120 million for financial incentives for patients, and thus all are cost-effective. The TNB of the ISTs that are directed to professionals ranges from €5.7 million for printed educational materials to €30.9 million for reminder systems. Of the strategies that are directed to patients, only the motivational program had a positive net benefit of €100.4 million. Conclusions: All the ISTs for cancer survivors, except for financial incentives, had a positive TNB. The largest improvements in adherence were created by a motivational program for patients, followed by a reminder system for professionals.
AB - Background: To increase the adherence of health professionals and cancer survivors to evidence-based physical exercise, effective implementation strategies (ISTs) are required. Objectives: To examine to what extent these ISTs provide value for money and which IST has the highest expected value. Methods: The net benefit framework of health economic evaluations is used to conduct a value-of-implementation analysis of nine ISTs. Seven are directed to health professionals and two to cancer survivors. The analysis consists of four steps: 1) analyzing the expected value of perfect implementation (EVPIM); 2) assessing the estimated costs of the various ISTs; 3) comparing the ISTs' costs with the EVPIM; and 4) assessing the total net benefit (TNB) of the ISTs. These steps are followed to identify which strategy has the greatest value. Results: The EVPIM for physical exercise in the Netherlands is €293 million. The total costs for the ISTs range from €34,000 for printed educational materials for professionals to €120 million for financial incentives for patients, and thus all are cost-effective. The TNB of the ISTs that are directed to professionals ranges from €5.7 million for printed educational materials to €30.9 million for reminder systems. Of the strategies that are directed to patients, only the motivational program had a positive net benefit of €100.4 million. Conclusions: All the ISTs for cancer survivors, except for financial incentives, had a positive TNB. The largest improvements in adherence were created by a motivational program for patients, followed by a reminder system for professionals.
KW - Cancer survivors
KW - Expected value of perfect implementation
KW - Guideline implementation
KW - Implementation research
KW - Physical exercise
KW - Rehabilitation
KW - Value-of-implementation analysis
KW - 22/4 OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85020849465&partnerID=8YFLogxK
U2 - 10.1016/j.jval.2017.04.013
DO - 10.1016/j.jval.2017.04.013
M3 - Article
AN - SCOPUS:85020849465
SN - 1098-3015
VL - 20
SP - 1336
EP - 1344
JO - Value in health
JF - Value in health
IS - 10
ER -
