{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:55:49Z","timestamp":1790297749429,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The present study aimed to perform a cost\u2010effectiveness analysis of an exercise\u2010based cardiovascular rehabilitation (CR) program in patients with chronic Chagas cardiomyopathy (CCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cost\u2010effectiveness analysis alongside a randomised clinical trial evaluating the effects of a 6\u2010month exercise\u2010based CR program. The intervention group underwent 3 weekly exercise sessions. The variation of peak oxygen consumption (VO<jats:sub>2peak<\/jats:sub>) was used as a measurement of clinical outcome. Cost information from all healthcare expenses (examinations, healthcare visits, medication and hospitalisation) were obtained from the medical records in Brazilian reais (R$) and transformed into dollars using the purchasing power parity ($PPP). The longitudinal costs variation was evaluated through linear mixed models, represented by <jats:italic>\u03b2<\/jats:italic> coefficient, adjusted for the baseline values of the dependent variable. The cost\u2010effectiveness evaluation was determined through an incremental cost\u2010effectiveness ratio using the HEABS package (Stata 15.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intervention group presented higher costs with healthcare visits (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0+3317.3; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), hospitalisation (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0+2810.4; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02) and total cost (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0+6407.9; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) after 3 months of follow\u2010up. Costs related to healthcare visits (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0+2455.8; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and total cost (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0+4711.4; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) remained higher in the intervention group after 6 months. The CR program showed an incremental cost\u2010effectiveness ratio (ICER) of $PPP 1874.3 for each increase of 1.0\u00a0ml\u2009kg<jats:sup>\u22121<\/jats:sup>\u00a0min<jats:sup>\u22121<\/jats:sup> of VO<jats:sub>2peak<\/jats:sub>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The CR program can be considered a cost\u2010effective alternative and should be included as an intervention strategy in the care of patients with CCC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13784","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T06:05:21Z","timestamp":1653890721000},"page":"630-638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost\u2010effectiveness of an <scp>exercise\u2010based<\/scp> cardiovascular rehabilitation program in patients with chronic Chagas cardiomyopathy in Brazil: An analysis from the <scp>PEACH<\/scp> study"],"prefix":"10.1111","volume":"27","author":[{"given":"Valeria Alencar Linhares","family":"Sim\u00f5es","sequence":"first","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda de Souza Nogueira Sardinha","family":"Mendes","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Monken","family":"Avellar","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto Marcelo Sperandio","family":"da Silva","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Martins","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Simpl\u00edcio","family":"Silva","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Mazzoli\u2010Rocha","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudson Santos","family":"Silva","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Carvalho","family":"Vieira","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"},{"name":"Centre for Cardiology and Exercise Aloysio de Castro State Institute of Cardiology  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celson J\u00fanio do Nascimento","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Research and Education National Institute of Cardiology  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Silvestre","family":"de Sousa","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Maria Valete","family":"Rosalino","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia Fernandes da Silva","family":"Nobre","sequence":"additional","affiliation":[{"name":"National Institute Quality Control in Health, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Teixeira","family":"de Holanda","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique Silveira","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Healthy and Biological Sciences Federal University of Vales do Jequitinhonha e Mucuri (UFVJM)  Diamantina Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto Magalh\u00e3es","family":"Saraiva","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro Marcel","family":"Hasslocher\u2010Moreno","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Castro","sequence":"additional","affiliation":[{"name":"Sergio Arouca National School of Public Health Oswaldo Cruz Foundation  Rio de Janeiro Brazil"},{"name":"Institute of Collective Health, Federal University of the State of Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro Felippe Felix","family":"Mediano","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation  Rio de Janeiro Brazil"},{"name":"Department of Research and Education National Institute of Cardiology  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"PAHO issues new guide for diagnosis and treatment of Chagas disease","author":"PAHO","year":"2019"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0505-2016"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70002-1"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.13-0574"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31612-4"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000599"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487320913379"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.36660\/abc.20200407"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.11686"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfq123"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0083-2016"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.01.035"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2015.00164"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200406000-00003"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-311X2009001200002"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0657-2021"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-016-1553-4"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.03.007"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.05.014"},{"issue":"4","key":"e_1_2_6_21_1","article-title":"Cost\u2010effectiveness thresholds and the Brazilian unified National Health System","volume":"33","author":"Soarez PC","year":"2017","journal-title":"Cad Saude Publica"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1801800114"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.01.030"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2021.07.004"},{"key":"e_1_2_6_25_1","volume-title":"Chronic care for neglected infectious diseases: leprosy\/Hansen's disease, lymphatic Filariasis, trachoma, and Chagas disease","author":"PAHO","year":"2021"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0429-2016"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.4103\/jrms.JRMS_175_18"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e3182930c9f"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e318272153e"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2019.02.011"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4463-9"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312809"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.04.088"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000356"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2011.05.006"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2013.09.008"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2019.1577731"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldq033"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1590\/0074-02760180224"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13784","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.13784","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:35:48Z","timestamp":1692837348000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.13784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,14]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1111\/tmi.13784"],"URL":"https:\/\/doi.org\/10.1111\/tmi.13784","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,14]]},"assertion":[{"value":"2022-06-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}