"As du Coeur" study: a randomized controlled trial on quality of life impact and cost effectiveness of a physical activity program in patients with cardiovascular disease

BackgroundPhysical activity programs (PAP) in patients with cardiovascular disease require evidence of cost-utility. To assess improvement in health-related quality of life (QoL) and reduction of health care consumption of patients following PAP, a randomized trial was used.MethodsPatients from a health insurance company who had experienced coronary artery disease or moderate heart failure were invited to participate (N=1891). Positive responders (N=50) were randomly assigned to a progressively autonomous physical activity (PAPA) program or to a standard supervised physical activity (SPA) program. The SPA group had two supervised sessions per week over 5months. PAPA group had one session per week and support to aid habit formation (written tips, exercise program, phone call). To measure health-related quality of life EQ-5D utility score were used, before intervention, 6months (T6) and 1 year later. Health care costs were provided from reimbursement databases.ResultsMobility, usual activities and discomfort improved significantly in both group (T6). One year later, EQ-5D utility score was improved in the PAPA group only. Total health care consumption in the intervention group decreased, from a mean of 4097 euros per year before intervention to 2877 euros per year after (p=0.05), compared to a health care consumption of 4087 euros and 4180 euros per year, in the total population of patients (N=1891) from the health insurance company. The incremental cost effectiveness ratio was 10,928 euros per QALYs.ConclusionA physical activity program is cost-effective in providing a better quality of life and reducing health care consumption in cardiovascular patients.Trial registrationISRCTN77313697, retrospectively registered on 20 November 2015.