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Controlled Clinical Trial
. 2019 Jun 13;16(12):2086.
doi: 10.3390/ijerph16122086.

Effectiveness and Estimation of Cost-Effectiveness of a Group-Based Multicomponent Physical Exercise Programme on Risk of Falling and Frailty in Community-Dwelling Older Adults

Tamara Alhambra-Borrás  1 , Estrella Durá-Ferrandis  2 , Maite Ferrando-García  3
Affiliations
Controlled Clinical Trial

Effectiveness and Estimation of Cost-Effectiveness of a Group-Based Multicomponent Physical Exercise Programme on Risk of Falling and Frailty in Community-Dwelling Older Adults

Tamara Alhambra-Borrás et al. Int J Environ Res Public Health. .

Abstract

This study analyses the effectiveness and cost-effectiveness of a group-based multicomponent physical exercise programme aimed at reducing the risk of falling and frailty in community-dwelling older adults. This is a pretest-posttest non-equivalent control group design, with an intervention group and a comparison group. Participants were evaluated at baseline and after 9 months. The effectiveness analyses showed significant reduction in the risk of falling (-45.5%; p = 0.000) and frailty (-31%; p = 0.000) after the intervention for the participants in the physical exercise programme. Moreover, these participants showed an improvement in limitations in activities of daily living, self-care ability and the use of health resources, physical performance, balance and body mass index. The cost-effectiveness analyses showed that the intervention was cost-saving and more effective than usual care scenario. A novel group-based multicomponent physical exercise programme showed to be more effective and cost-effective than usual care for older adults suffering from risk of falling and frailty.

Keywords: ageing; falls; frailty; older adults; physical exercise; risk of falling.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow of participants through the study. a Inclusion criteria: Having risk of falling and/or frailty and, for intervention group, acceptance to participate in the physical exercise programme. * Experimental mortality includes the participants who dropped out of the study after having met the inclusion criteria.
Figure 2
Figure 2
Incremental cost by age (healthcare). Figure 2 presents incremental costs for every age-gender combination in the specified target population. * Undiscounted incremental costs are those not applying the discount factors for costs and effects which are used to estimate outcomes while taking into account the future costs and health effects. This means adjusting for differences in the timing of costs (estimated expenditure) compared to health benefits (outcomes). The discount factor rate applied to this study was 3.5% for both cost and outcomes.
Figure 3
Figure 3
Incremental effects by age. Figure 3 presents incremental effects for every age-gender combination in the specified target population.
Figure 4
Figure 4
Cost-effectiveness plane (healthcare costs). Figure 4 presents the overall impact of the intervention on the costs and effects of the whole target population ICER: incremental cost-effectiveness ratio; WTP Threshold: willingness to pay (WTP) threshold per quality-adjusted life-year (QALY).
See this image and copyright information in PMC

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