Exploring the Economic Implications of a Group-Based Lifestyle Intervention for Middle-Aged Adults with Chronic Schizophrenia and Co-Morbid Type 2 Diabetes

Abstract

Objective: People with schizophrenia are at elevated risk of having type 2 diabetes, compared to the general population. Although there is a growing body of literature on the effectiveness of behavioural interventions to improve physical activity levels and healthy eating habits, there are very few economic evaluations conducted for people with severe mental illness and physical health problems. The aim of this study is to explore the cost-effectiveness of group-based lifestyle interventions for middle-aged adults with enduring long-term schizophrenia and co-morbid type 2 diabetes. Methods: Deterministic decision analytical modelling techniques are applied to explore cost-effectiveness based on the findings from a systematic review on this population. The intervention refers to a group-based lifestyle intervention, which is a combination of exercise, diet and diabetes education over 6 months. The intervention costs are estimated to reflect the UK local context. Results: From the UK National Health Service perspective, the group-based lifestyle intervention is potentially cost-effective, relative to usual care. It costs £80 to achieve an additional unit of Body Mass Index (BMI) lost and the incremental cost-effectiveness ratio is just below £700 to gain an extra Quality Adjusted Life Year, which lies well within the conventionally acceptable threshold values in the UK. Conclusions: Group based life style intervention for this population is effective and can be cost-effective in reducing BMI and improving diabetes knowledge, at least in the short-term. More co-ordinated policies among relevant sectors are required to facilitate behavioural change and better maintain an improved lifestyle. An integrated approach is needed to make this more sustainable in the long-term.