ORCID Profile
0000-0002-5974-4093
Current Organisations
Monash University
,
Phynova Group Limited
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Publisher: Springer Science and Business Media LLC
Date: 27-09-2022
DOI: 10.1007/S40258-022-00759-4
Abstract: There is a paucity of papers synthesizing the cost-effectiveness (CE) of lifestyle interventions to support cancer patients, and the synthesis papers available have used analytic methods that do not permit easy comparison between studies. We therefore evaluated the CE of adjunctive lifestyle interventions compared with usual care. A systematic literature search of Scopus, MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library databases was conducted from database inception until June 2021. Eligible studies were economic evaluations from randomised controlled trials or modelled economic evaluations that recruited subjects with a confirmed diagnosis of cancer and were allocated to a lifestyle intervention as an adjunct or supportive treatment, or usual care. Studies were excluded if there was no cost-effectiveness analysis or if costs were identified but not related back to measures of effectiveness. CE of the included interventions was recalculated, adjusting for key differences (with respect to absolute resource costs and timing) between the broad range of study settings and a common 'target' setting. All CE data were converted into incremental net monetary benefit using a common cost-effectiveness threshold to facilitate comparison. The quality of the studies was evaluated for risk of bias using the ECOBIAS check list. Nine studies were included in our review. Seven studies investigated the benefits of physical exercise in combination with cancer treatment and two studies investigated the combination of exercise and psychosocial counselling alongside cancer treatment. Six studies with an exercise intervention reported larger quality-adjusted life year (QALY) gains compared with usual care and when cost per QALY gained was considered, three of the interventions were cost effective. One of the two interventions combining exercise with psychosocial counselling was cost effective. All studies were considered of good quality but all had some limitations. The evidence to support the cost effectiveness of lifestyle interventions in patients with cancer is mixed with four of the nine interventions found to be cost effective and two remaining cost effective when uncertainty was taken into account. Sensitivity analysis showed the influence of the CE threshold on the results, highlighting the importance of selecting a CE threshold that is appropriate to the setting. PROSPERO Registration Number: CRD42020185376.
Publisher: Public Library of Science (PLoS)
Date: 22-02-2017
Publisher: Springer Science and Business Media LLC
Date: 26-05-2021
DOI: 10.1186/S12986-021-00577-W
Abstract: An amendment to this paper has been published and can be accessed via the original article.
Publisher: Springer Science and Business Media LLC
Date: 15-04-2021
DOI: 10.1186/S12986-021-00571-2
Abstract: There are many benefits of maintaining healthy blood glucose levels, and studies have shown that lifestyle changes such as changes to diet can successfully restore normoglycaemia in participants with dysglycaemia. Significant health-related lifestyle changes are often difficult to implement and functional ingredients that can reduce glycaemic and insulaemic responses may help at risk populations. The aim of this study was to investigate whether a mulberry leaf extract could lower the glycaemic and insulinaemic responses to 75 g sucrose in healthy in iduals. A double-blind, randomised, placebo-controlled, crossover design trial was conducted by the Oxford Brookes Centre for Nutrition and Health. Thirty-eight participants were recruited into the trial and, after an overnight fast, were given 75 g sucrose + white mulberry leaf extract, or 75 g sucrose alone. Capillary blood s les were collected at 15-min intervals in the first hour and at 30-min intervals over the second hour to determine glucose and plasma insulin levels. Data analysis was conducted using a paired s les T test or a Wilcoxon signed rank test. The addition of mulberry leaf extract to sucrose resulted in a significantly lower glycaemic response and insulinaemic response compared to a matched placebo (sucrose alone). The change in blood glucose measurements were significantly lower at 15 min (p 0.001), 30 min (p 0.001), 45 min (p = 0.008), and 120 min (p 0.001) and plasma insulin measurements were significantly lower at 15 min (p 0.001), 30 min (p 0.001), 45 min (p 0.001), 60 min (p = 0.001) and 120 min (p 0.001). The glucose iAUC (− 42%, p = 0.001), insulin iAUC (− 40%, p 0.001), peak glucose (− 40.0%, p 0.001) and peak insulin (− 41%, p 0.001) from baseline were significantly lower for white mulberry leaf extract compared with the placebo . White mulberry leaf extract was well tolerated and there were no reported adverse events. Mulberry leaf extract can be used as part of lifestyle changes that may lead to healthy blood glucose levels. Trial registration : ISRCTN99601810 (23 October 2020, retrospectively registered)
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Andrew Gallagher.