Long-term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study.
Identifieur interne : 000D57 ( PubMed/Corpus ); précédent : 000D56; suivant : 000D58Long-term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study.
Auteurs : Charlotte Lanhers ; Guillaume Walther ; Robert Chapier ; Bruno Lesourd ; Geraldine Naughton ; Bruno Pereira ; Martine Duclos ; Agnès Vinet ; Philippe Obert ; Daniel Courteix ; Frédéric DutheilSource :
- BMJ open [ 2044-6055 ] ; 2017.
English descriptors
- KwdEn :
- Blood Glucose (analysis), Cost-Benefit Analysis, Diabetes Mellitus, Type 2 (drug therapy), Exercise, Female, France, Hemoglobin A, Glycosylated (analysis), Humans, Hypoglycemic Agents (economics), Hypoglycemic Agents (therapeutic use), Life Style, Male, Middle Aged, Multivariate Analysis, Nutritional Status, Prospective Studies, Quality of Life, Regression Analysis, Time Factors, Treatment Outcome.
- MESH :
- chemical , analysis : Blood Glucose, Hemoglobin A, Glycosylated.
- drug therapy : Diabetes Mellitus, Type 2.
- chemical , economics : Hypoglycemic Agents.
- chemical , therapeutic use : Hypoglycemic Agents.
- Cost-Benefit Analysis, Exercise, Female, France, Humans, Life Style, Male, Middle Aged, Multivariate Analysis, Nutritional Status, Prospective Studies, Quality of Life, Regression Analysis, Time Factors, Treatment Outcome.
Abstract
To demonstrate that lifestyle modifications will reduce the cost of routine medications in individuals with type 2 diabetes (T2D), through a mechanism involving glycaemic control.
DOI: 10.1136/bmjopen-2016-013763
PubMed: 28416496
Links to Exploration step
pubmed:28416496Le document en format XML
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France.</nlm:affiliation></affiliation></author><author><name sortKey="Chapier, Robert" sort="Chapier, Robert" uniqKey="Chapier R" first="Robert" last="Chapier">Robert Chapier</name><affiliation><nlm:affiliation>Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France.</nlm:affiliation></affiliation></author><author><name sortKey="Lesourd, Bruno" sort="Lesourd, Bruno" uniqKey="Lesourd B" first="Bruno" last="Lesourd">Bruno Lesourd</name><affiliation><nlm:affiliation>Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France.</nlm:affiliation></affiliation></author><author><name sortKey="Naughton, Geraldine" sort="Naughton, Geraldine" uniqKey="Naughton G" first="Geraldine" last="Naughton">Geraldine Naughton</name><affiliation><nlm:affiliation>Australian Catholic University, 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psychosocial stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, Sports Medicine, F-63000 Clermont-Ferrand, France.</nlm:affiliation></affiliation></author><author><name sortKey="Walther, Guillaume" sort="Walther, Guillaume" uniqKey="Walther G" first="Guillaume" last="Walther">Guillaume Walther</name><affiliation><nlm:affiliation>Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Chapier, Robert" sort="Chapier, Robert" uniqKey="Chapier R" first="Robert" last="Chapier">Robert Chapier</name><affiliation><nlm:affiliation>Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France.</nlm:affiliation></affiliation></author><author><name sortKey="Lesourd, Bruno" sort="Lesourd, Bruno" uniqKey="Lesourd B" first="Bruno" last="Lesourd">Bruno 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last="Duclos">Martine Duclos</name><affiliation><nlm:affiliation>Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, CHU Clermont-Ferrand, Sports Medicine, F-63000 Clermont-Ferrand, France.</nlm:affiliation></affiliation></author><author><name sortKey="Vinet, Agnes" sort="Vinet, Agnes" uniqKey="Vinet A" first="Agnès" last="Vinet">Agnès Vinet</name><affiliation><nlm:affiliation>Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Obert, Philippe" sort="Obert, Philippe" uniqKey="Obert P" first="Philippe" last="Obert">Philippe Obert</name><affiliation><nlm:affiliation>Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Courteix, Daniel" sort="Courteix, Daniel" uniqKey="Courteix D" first="Daniel" last="Courteix">Daniel Courteix</name><affiliation><nlm:affiliation>Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France.</nlm:affiliation></affiliation></author><author><name sortKey="Dutheil, Frederic" sort="Dutheil, Frederic" uniqKey="Dutheil F" first="Frédéric" last="Dutheil">Frédéric Dutheil</name><affiliation><nlm:affiliation>Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMJ open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Blood Glucose (analysis)</term><term>Cost-Benefit Analysis</term><term>Diabetes Mellitus, Type 2 (drug therapy)</term><term>Exercise</term><term>Female</term><term>France</term><term>Hemoglobin A, Glycosylated (analysis)</term><term>Humans</term><term>Hypoglycemic Agents (economics)</term><term>Hypoglycemic Agents (therapeutic use)</term><term>Life Style</term><term>Male</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Nutritional Status</term><term>Prospective Studies</term><term>Quality of Life</term><term>Regression Analysis</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analysis" xml:lang="en"><term>Blood Glucose</term><term>Hemoglobin A, Glycosylated</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Diabetes Mellitus, Type 2</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Hypoglycemic Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Hypoglycemic Agents</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cost-Benefit Analysis</term><term>Exercise</term><term>Female</term><term>France</term><term>Humans</term><term>Life Style</term><term>Male</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Nutritional Status</term><term>Prospective Studies</term><term>Quality of Life</term><term>Regression Analysis</term><term>Time Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To demonstrate that lifestyle modifications will reduce the cost of routine medications in individuals with type 2 diabetes (T2D), through a mechanism involving glycaemic control.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28416496</PMID><DateCreated><Year>2017</Year><Month>04</Month><Day>18</Day></DateCreated><DateCompleted><Year>2017</Year><Month>09</Month><Day>11</Day></DateCompleted><DateRevised><Year>2017</Year><Month>11</Month><Day>16</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">2044-6055</ISSN><JournalIssue CitedMedium="Internet"><Volume>7</Volume><Issue>4</Issue><PubDate><Year>2017</Year><Month>Apr</Month><Day>16</Day></PubDate></JournalIssue><Title>BMJ open</Title><ISOAbbreviation>BMJ Open</ISOAbbreviation></Journal><ArticleTitle>Long-term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study.</ArticleTitle><Pagination><MedlinePgn>e013763</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/bmjopen-2016-013763</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To demonstrate that lifestyle modifications will reduce the cost of routine medications in individuals with type 2 diabetes (T2D), through a mechanism involving glycaemic control.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">A within-trial cost-medication analysis with a 1-year time horizon.</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">Controlled environment within the spa resort of Chatel-Guyon, France.</AbstractText><AbstractText Label="PARTICIPANTS" NlmCategory="METHODS">Twenty-nine participants (aged 50-70 years) with T2D.</AbstractText><AbstractText Label="INTERVENTIONS" NlmCategory="METHODS">A 1-year follow-up intervention, beginning with a 3-week residential programme combining high exercise volume (15-20 hours/week), restrictive diet (-500 kcal/day) and education. Participants continued their routine medication, independently managed by their general practitioner.</AbstractText><AbstractText Label="MAIN OUTCOME MEASURES" NlmCategory="METHODS">Number of medications, number of pills, cost of medications and health-related outcomes.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Twenty-six participants completed the 1-year intervention. At 1 year, 14 patients out of 26 (54%) stopped/decreased their medications whereas only 5 (19%) increased or introduced new drugs (χ(2)=6.3, p=0.02). The number of pills per day decreased by 1.3±0.3 at 12 months (p<0.001). The annual cost of medications for T2D were lower at 1 year (€135.1±43.9) versus baseline (€212.6±35.8) (p=0.03). The regression coefficients on costs of routine medication were 0.507 (95% CI 0.056 to 0.959, p=0.027) for HbA1c and 0.156 (95% CI -0.010 to 0.322, p=0.06) for blood glucose levels. Diabetics patients with HbA1c >6.5% in the highest (last) quartile doubled their routine medication costs (66% vs 33%, p=0.037).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Individuals with T2D reduced routine medication costs following a long-term lifestyle intervention that started with a 3-week residential programme. Combining high exercise volume, restrictive diet and education effectively supported the health of T2D. The main factor explaining reduced medication costs was better glycaemic control, independent of weight changes. Despite limitations precluding generalisability, cost-effective results of reduced medication should contribute to the evidence base required to promote lifestyle interventions for individuals with T2D.</AbstractText><AbstractText Label="TRIAL REGISTRATION NUMBER" NlmCategory="BACKGROUND">NCT00917917; Post-results.</AbstractText><CopyrightInformation>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lanhers</LastName><ForeName>Charlotte</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Université Clermont Auvergne, CNRS, LaPSCo, Physiological and psychosocial stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, Sports Medicine, F-63000 Clermont-Ferrand, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walther</LastName><ForeName>Guillaume</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chapier</LastName><ForeName>Robert</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lesourd</LastName><ForeName>Bruno</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Naughton</LastName><ForeName>Geraldine</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pereira</LastName><ForeName>Bruno</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>CHU Clermont-Ferrand, the Clinical Research and Innovation Direction, F-63000 Clermont-Ferrand, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Duclos</LastName><ForeName>Martine</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, CHU Clermont-Ferrand, Sports Medicine, F-63000 Clermont-Ferrand, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vinet</LastName><ForeName>Agnès</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Obert</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Courteix</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dutheil</LastName><ForeName>Frédéric</ForeName><Initials>F</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-1468-6029</Identifier><AffiliationInfo><Affiliation>Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Université Clermont Auvergne, CNRS, LaPSCo, Physiological and psychosocial stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, F-63000 Clermont-Ferrand, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>04</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ Open</MedlineTA><NlmUniqueID>101552874</NlmUniqueID><ISSNLinking>2044-6055</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D001786">Blood Glucose</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006442">Hemoglobin A, Glycosylated</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007004">Hypoglycemic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001786" MajorTopicYN="N">Blood Glucose</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="N">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003924" MajorTopicYN="N">Diabetes Mellitus, Type 2</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015444" MajorTopicYN="Y">Exercise</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005602" MajorTopicYN="N">France</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006442" MajorTopicYN="N">Hemoglobin A, Glycosylated</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="N">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007004" MajorTopicYN="N">Hypoglycemic Agents</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008019" MajorTopicYN="N">Life Style</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015999" MajorTopicYN="N">Multivariate Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009752" MajorTopicYN="Y">Nutritional Status</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012044" MajorTopicYN="N">Regression Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">MEDICAL EDUCATION & TRAINING</Keyword><Keyword MajorTopicYN="N">NUTRITION & DIETETICS</Keyword></KeywordList><CoiStatement>Competing interestsNone declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate 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