A multidisciplinary lifestyle programme for patients with rheumatoid arthritis and metabolic syndrome-associated osteoarthritis: economic evaluation alongside the 'Plants for Joints' randomized controlled trials

Dongen, J.M. van; Bernaers, L.; Wagenaar, C. A.; Leeden, M. van der; Turkstra, F.; Boers, M.; Middendorp, H. van; Weijs, P.J.M.; Schaardenburg, D. van; Walrabenstein, W.

doi:doi:10.1080/03009742.2025.2550133

ObjectiveTo evaluate the cost-effectiveness of the 'Plants for Joints' intervention for rheumatoid arthritis (RA) and metabolic syndrome-associated osteoarthritis (MSOA) patients over 16 weeks.MethodData from two randomized controlled trials were analysed. The first included 77 RA patients (intervention = 40; control = 37) and the second 64 MSOA patients (intervention = 32; control = 32). The intervention comprised a 16 week lifestyle programme including a whole-food plant-based diet, exercise, and stress management; control participants received usual care. Data from both trials were analysed together and separately. Costs were measured from societal and healthcare perspectives. Effects were expressed in quality-adjusted life-years (QALYs).ResultsThe intervention cost 886/patient. Intervention group participants gained more QALYs than the control group (0.009; 95% confidence interval -0.004 to 0.023), equivalent to 3.3 additional days in 'perfect health' (0.009 x 365). Healthcare...Show moreObjectiveTo evaluate the cost-effectiveness of the 'Plants for Joints' intervention for rheumatoid arthritis (RA) and metabolic syndrome-associated osteoarthritis (MSOA) patients over 16 weeks.MethodData from two randomized controlled trials were analysed. The first included 77 RA patients (intervention = 40; control = 37) and the second 64 MSOA patients (intervention = 32; control = 32). The intervention comprised a 16 week lifestyle programme including a whole-food plant-based diet, exercise, and stress management; control participants received usual care. Data from both trials were analysed together and separately. Costs were measured from societal and healthcare perspectives. Effects were expressed in quality-adjusted life-years (QALYs).ResultsThe intervention cost 886/patient. Intervention group participants gained more QALYs than the control group (0.009; 95% confidence interval -0.004 to 0.023), equivalent to 3.3 additional days in 'perfect health' (0.009 x 365). Healthcare costs were higher in the intervention group, while societal costs were lower. None of these differences was statistically significant. From a societal perspective, the intervention had a moderate to high probability of being cost-effective compared with usual care, while the probability was low from a healthcare perspective. Stratified analyses indicated that the probability of cost-effectiveness was higher in RA than in MSOA patients. This difference became less pronounced after excluding outliers.ConclusionThe Plants for Joints intervention demonstrated a relatively high probability of cost-effectiveness from a societal perspective, although this was lower from a healthcare perspective. If these benefits are sustained in the long term, this intervention may reduce the disease and economic burden of arthritic conditions.Show less

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A multidisciplinary lifestyle programme for patients with rheumatoid arthritis and metabolic syndrome-associated osteoarthritis: economic evaluation alongside the 'Plants for Joints' randomized controlled trials