Economic evaluation of workplace health promotion interventions focused on Lifestyle: Systematic review and meta-analysis

Abstract

Aim: To identify and evaluate randomized clinical trials focusing on economic evaluation of workplace health promotion (WHP) interventions based on healthy lifestyles, physical activity and nutrition.

Design: A systematic review and meta-analysis was carried out between March and May 2019, following the PRISMA statement.

Data sources: The literature search was conducted on Cochrane Library, Scopus, WOS and Medline databases.

Review methods: The quality appraisal included the overall risk of bias (Cochrane Collaboration tool), the quality of the evidence (GRADEpro) and the quality of the health economic analysis (QHES instrument).

Results: Of the 15 studies selected, 3 were interventions based on nutrition, 11 were focused on lifestyle and only one on physical activity. Given the heterogeneity of included studies, it was decided to do a subgroup analysis. For the weight loss (n = 5 studies), a general increase of 0.56 Kg (95% CI = 0.76, 0.84) I² = 99.41%, and for the Quality-adjusted Life Years achieved (n = 5 studies) a very small increase of 0.003 (95% CI = 0.002, 0.004) I² = 99.25%, were observed.

Conclusions: The implementation of lifestyle interventions in the workplace has proven to be cost-effective for both employers and society.

Impact: What problem did the study address? There are few studies aimed at evaluating the efficiency of WHP interventions. However, those that identify and assessing interventions related to lifestyle are particularly scarce, despite the evidence showing that these researchers improve the quality of care of occupational health. What were the main findings? This systematic review demonstrates the effectiveness of the WHP interventions, and in some cases, the efficiency of these interventions for both employers and society. Additional research in this area is necessary as well as the assessment of the cost-effectiveness of such interventions. Where and on whom will the research have an impact? To know the cost-benefit of different WHP interventions allows more efficient management of resources, which helps to make political and business decisions, becoming healthier and safer workplaces.

Keywords: cost-benefit; meta-analysis; nursing; occupational health; systematic review; workplace health promotion.