Economic evaluation of the e-Health StandingTall balance exercise programme for fall prevention in people aged 70 years and over

Meghan Ambrens, Kimberley S van Schooten, Thomas Lung, Lindy Clemson, Jacqueline C T Close, Kirsten Howard, Stephen R Lord, G A Rixt Zijlstra, Anne Tiedemann, Trinidad Valenzuela, Corneel Vandelanotte, Jessica Chow, Garth McInerney, Lillian Miles, Ashley Woodbury, Kim Delbaere*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: globally, falls and fall-related injuries are the leading cause of injury-related morbidity and mortality in older people. In our ageing society healthcare costs are increasing, therefore programmes that reduce falls and are considered value for money are needed.

OBJECTIVE: to complete an economic evaluation of an e-Health balance exercise programme that reduced falls and injurious falls in community-dwelling older people compared to usual care from a health and community-care funder perspective.

DESIGN: a within-trial economic evaluation of an assessor-blinded randomised controlled trial with 2 years of follow-up.

SETTING: StandingTall was delivered via tablet-computer at home to older community-dwelling people in Sydney, Australia.

PARTICIPANTS: five hundred and three individuals aged 70+ years who were independent in activities of daily living, without cognitive impairment, progressive neurological disease or any other unstable or acute medical condition precluding exercise.

MAIN OUTCOME MEASURES: cost-effectiveness was measured as the incremental cost per fall and per injurious fall prevented. Cost-utility was measured as the incremental cost per quality-adjusted life year (QALY) gained.

MAIN RESULTS: the total average cost per patient for programme delivery and care resource cost was $8,321 (standard deviation [SD] 18,958) for intervention participants and $6,829 (SD 15,019) for control participants. The incremental cost per fall prevented was $4,785 and per injurious fall prevented was $6,585. The incremental cost per QALY gained was $58,039 (EQ5D-5L) and $110,698 (AQoL-6D).

CONCLUSION: this evaluation found that StandingTall has the potential to be cost-effective in specific subpopulations of older people, but not necessarily the whole older population.

TRIAL REGISTRATION: ACTRN12615000138583.

Original languageEnglish
Article numberafac130
Number of pages10
JournalAge and Ageing
Volume51
Issue number6
DOIs
Publication statusPublished - 1 Jun 2022

Keywords

  • older people
  • mHealth
  • home exercise
  • cost-effectiveness
  • physical activity
  • OLDER-PEOPLE
  • MONEY
  • CARE

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