Cost-effectiveness of physical activity-oriented interventions for improving mental health: a systematic review

QUESTION: Are physical activity-oriented interventions for improving mental health conditions cost-effective? This study systematically identified and summarized published evidence on the cost-effectiveness of physical activity-oriented interventions for improving mental health conditions. STUDY SELECTION AND ANALYSIS: We searched four databases (PubMed/Medline, Science Direct, PsychArticles, PsychINFO) for published studies (from any time and region) that (1) assessed physical activity-oriented interventions in mental health disorders, (2) undertook a full economic evaluation (and specifically cost-effectiveness analysis or cost-utility analysis), and (3) were in English. Data were extracted from included studies using a predetermined 32-item matrix using the Covidence software platform. FINDINGS: Search and screening resulted in 11 studies eligible for inclusion. The incremental cost-effectiveness ratio ranged from £119 to £152,822 per quality-adjusted life year (QALY) gained. Physical activity interventions, including group sessions, such as dance exercise and walking, or one-on-one support through telephone or web-based personalized support and guidance, were found to be cost-effective. However, over half of the interventions (55%) were considered to be not cost-effective. CONCLUSIONS: Our review found that the current evidence is insufficient to conclude whether physical activity-oriented interventions for mental health are a cost-effective when compared with the standard of care of other treatment types. Better designed studies focusing on specific mental health conditions and physical activity interventions that address cost-effectiveness analysis are warranted. Physical activity-oriented interventions for improving mental health should adopt low-cost implementation strategies and include behavioral economics components.