A population-based comprehensive lifestyle intervention to promote healthy weight and physical activity in people with cardiac disease: The PANACHE (Physical Activity, Nutrition And Cardiac HEalth) study
Key Objectives
To determine the effectiveness and cost-effectiveness of a telephone-delivered lifestyle intervention, focusing on healthy weight and physical activity, in people with cardiovascular disease in urban and rural settings
Cardiovascular disease (CVD) is the leading cause of death and the most costly disease group treated in Australia. Maintaining a healthy weight and undertaking regular physical activity are important for the primary and secondary prevention of CVD. However, many people with CVD are overweight and insufficiently active. In addition, in Australia only 20 to 30% of people requiring cardiac rehabilitation (CR) for CVD actually attend. To improve outcomes of and access to CR, the efficacy, effectiveness and cost-effectiveness of alternative approaches of CR need to be established.
PANACHE is a randomised controlled trial, including an economic evaluation, of patients who have been referred to a CR program. The intervention group receives an 8 week comprehensive lifestyle intervention which comprises of 4 behavioural counselling and goal setting sessions on weight, nutrition and physical activity via telephone; written materials and a pedometer via mail. The control group receives 2 behavioural counselling and goal setting sessions by telephone on physical activity only, plus the written materials and pedometer. Participants complete a pre-questionnaire and two post-questionnaires at 8 weeks and 8 months. The primary outcome is healthy weight (i.e. body mass index). Secondary outcomes include physical activity, sedentary time and reported relevant nutritional habits. Information about resource use and health related quality of life is collected pre and post trial as inputs into the economic evaluation.
CHERE’s role is to determine the relative cost-effectiveness of these approaches to the secondary prevention of CVD. The results of the trial will be used to build a decision analytic model of costs and benefits from within the trial and beyond the trial period. This will be done by extrapolating the intermediate clinical (healthy weight and physical activity levels) and quality of life (QALYs) endpoints to the final outcomes (death or cardiovascular events) using epidemiological data. Results will be presented as incremental cost-effectiveness and cost-utility ratios. This will allow comparison of the healthy weight intervention group and the control group in terms of, for example, cost per kilogram lost or cost per QALY gained. The trial protocol has been published.
Sangster, J., Furber, S., Allman-Farinelli, M.A., Haas, M.R., Phongsavan, P., Mark, A. & Bauman, A.E. 2010, 'A population-based lifestyle intervention to promote healthy weight and physical activity in people with cardiac disease: The PANACHE (Physical Activity, Nutrition And Cardiac HEalth) study protocol', BMC Cardiovascular Disorders, vol. 10, no. 17, pp. 1-8.
Funding Source
NSW Health Promotion Demonstration Research Grant 2008/2009
CHERE Staff
Marion Haas, Jody Church
Collaborators
Janice Sangster1, Susan Furber1,2, Margaret Allman-Farinelli3, Philayrath Phongsavan3, Andy Mark4, Adrian Bauman3
1. Health Promotion Service, South Eastern Sydney and Illawara Area Health Service
2. University of New South Wales
3. University of Sdyney
4. Heart Foundation
