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

doi:10.1093/ageing/afac130

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 journal › Article › Academic › peer-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 language	English
Article number	afac130
Number of pages	10
Journal	Age and Ageing
Volume	51
Issue number	6
DOIs	https://doi.org/10.1093/ageing/afac130
Publication status	Published - 1 Jun 2022

Keywords

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

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10.1093/ageing/afac130

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Ambrens, M., van Schooten, K. S., Lung, T., Clemson, L., Close, J. C. T., Howard, K., Lord, S. R., Zijlstra, G. A. R., Tiedemann, A., Valenzuela, T., Vandelanotte, C., Chow, J., McInerney, G., Miles, L., Woodbury, A., & Delbaere, K. (2022). Economic evaluation of the e-Health StandingTall balance exercise programme for fall prevention in people aged 70 years and over. Age and Ageing, 51(6), Article afac130. https://doi.org/10.1093/ageing/afac130

@article{a75c09244aa24e05962dca5160c405de,

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

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.",

keywords = "older people, mHealth, home exercise, cost-effectiveness, physical activity, OLDER-PEOPLE, MONEY, CARE",

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

year = "2022",

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doi = "10.1093/ageing/afac130",

language = "English",

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Ambrens, M, van Schooten, KS, Lung, T, Clemson, L, Close, JCT, Howard, K, Lord, SR, Zijlstra, GAR, Tiedemann, A, Valenzuela, T, Vandelanotte, C, Chow, J, McInerney, G, Miles, L, Woodbury, A & Delbaere, K 2022, 'Economic evaluation of the e-Health StandingTall balance exercise programme for fall prevention in people aged 70 years and over', Age and Ageing, vol. 51, no. 6, afac130. https://doi.org/10.1093/ageing/afac130

TY - JOUR

T1 - Economic evaluation of the e-Health StandingTall balance exercise programme for fall prevention in people aged 70 years and over

AU - Ambrens, Meghan

AU - van Schooten, Kimberley S

AU - Lung, Thomas

AU - Clemson, Lindy

AU - Close, Jacqueline C T

AU - Howard, Kirsten

AU - Lord, Stephen R

AU - Zijlstra, G A Rixt

AU - Tiedemann, Anne

AU - Valenzuela, Trinidad

AU - Vandelanotte, Corneel

AU - Chow, Jessica

AU - McInerney, Garth

AU - Miles, Lillian

AU - Woodbury, Ashley

AU - Delbaere, Kim

PY - 2022/6/1

Y1 - 2022/6/1

N2 - 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.

AB - 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.

KW - older people

KW - mHealth

KW - home exercise

KW - cost-effectiveness

KW - physical activity

KW - OLDER-PEOPLE

KW - MONEY

KW - CARE

U2 - 10.1093/ageing/afac130

DO - 10.1093/ageing/afac130

M3 - Article

C2 - 35679193

SN - 0002-0729

VL - 51

JO - Age and Ageing

JF - Age and Ageing

IS - 6

M1 - afac130

ER -

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

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Keywords

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