Khan, Kamran, Mazuquin , Bruno, Canaway , Alastair, Petrou, Stavros and Bruce, J. (Julie) (2019) Systematic review of economic evaluations of exercise and physiotherapy for patients treated for breast cancer. Breast Cancer Research and Treatment . doi:10.1007/s10549-019-05235-7 (In Press)

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Abstract

Purpose

Treatments for breast cancer can lead to chronic musculoskeletal problems. This study aimed to systematically review the evidence surrounding the cost-effectiveness of exercise and physiotherapy interventions aimed at reducing the risk of physical symptoms and functional limitations due to breast cancer treatment.

Methods

A systematic review of the cost-effectiveness of exercise and physiotherapy interventions during and following treatment for breast cancer was undertaken according to PRISMA guidelines. Literature searches were carried out in Ovid MEDLINE, Ovid Embase, Web of Science, EconLit, CINAHL, PsycINFO, Scopus and the Cochrane Library. Cost-effectiveness evidence was summarised in a descriptive manner and studies were assessed using quality appraisal tools. The review protocol was registered on PROSPERO.

Results

A total of 7783 articles were identified and seven were included in the final review. Five studies undertook trial-based economic evaluations, whereas two studies conducted economic evaluation based on decision models. One study was a cost-effectiveness analysis (CEA), three undertook stand-alone cost–utility analyses (CUA) and three studies were combined CEAs and CUAs. Three studies reported favourable cost-effectiveness results for different exercise or physiotherapy interventions. In contrast, four studies found that exercise and physiotherapy interventions were not cost-effective on the basis of quality-adjusted life year outcomes.

Conclusions

The evidence surrounding the cost-effectiveness of exercise and physiotherapy interventions for the treatment of breast cancer remains sparse with contrasting conclusions. Future research should particularly aim to broaden the evidence base by disentangling the contributing effects of frequency, intensity, time and type of exercise and physiotherapy interventions on cost-effectiveness outcomes.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RM Therapeutics. Pharmacology
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Physical therapy, Cancer -- Patients -- Rehabilitation -- Cost effectiveness
Journal or Publication Title:	Breast Cancer Research and Treatment
Publisher:	Springer
ISSN:	0167-6806
Official Date:	17 April 2019
Dates:	Date Event 17 April 2019 Published 10 April 2019 Accepted
Date of first compliant deposit:	11 April 2019
DOI:	10.1007/s10549-019-05235-7
Status:	Peer Reviewed
Publication Status:	In Press
Publisher Statement:	This is a post-peer-review, pre-copyedit version of an article published in Breast Cancer Research and Treatment. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10549-019-05235-7
Access rights to Published version:	Open Access
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID RMRCT0127 Health Technology Assessment programme http://dx.doi.org/10.13039/501100000664
Related URLs:	Publisher

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