Cost-Effectiveness of an Exercise Programme That Provided Group or Individual Training to Reduce the Fall Risk in Healthy Community-Dwelling People Aged 65–80: A Secondary Data Analysis

Abstract

Research has demonstrated that some exercise programs are effective for reducing fall rates in community-dwelling older people; however, the literature is limited in providing clear recommendations of individual or group training as a result of economic evaluation. The objective of this study was to assess the cost-effectiveness of the Otago Exercise Program (OEP) for reducing the fall risk in healthy, non-institutionalized older people. An economic evaluation of a multicenter, blinded, randomized, non-inferiority clinical trial was performed on 498 patients aged over 65 in primary care. Participants were randomly allocated to the treatment or control arms, and group or individual training. The program was delivered in primary healthcare settings and comprised five initial sessions, ongoing encouragement and support to exercise at home, and a reinforcement session after six months. Our hypothesis was that the patients who received the intervention would achieve better health outcomes and therefore need lower healthcare resources during the follow-up, thus, lower healthcare costs. The primary outcome was the incremental cost-effectiveness ratio, which used the timed up and go test results as an effective measure for preventing falls. The secondary outcomes included differently validated tools that assessed the fall risk. The cost per patient was USD 51.28 lower for the group than the individual sessions in the control group, and the fall risk was 10% lower when exercises had a group delivery. The OEP program delivered in a group manner was superior to the individual method. We observed slight differences in the incremental cost estimations when using different tools to assess the risk of fall, but all of them indicated the dominance of the intervention group. The OEP group sessions were more cost-effective than the individual sessions, and the fall risk was 10% lower.

Effect of a multicomponent exercise program and cognitive stimulation (VIVIFRAIL-COGN) on falls in frail community older persons with high risk of falls: study protocol for a randomized multicenter control trial

“…It consists of several strength, endurance, flexibility and balance exercises supervised by a physical therapist. It has shown to be effective in improving fall-related risk factors [ 58 – 60 ] and preventing falls [ 61 , 62 ] and related consequences [ 63 , 64 ]. Notably, several adaptations have been performed since it was firstly designed, leading to a high degree of heterogeneity, with mixed results obtained from different delivery fashions [ 65 – 67 ].…”

Comparative effectiveness of different modes of exercise interventions in diabetics with frailty in China: a systematic review and a network meta-analysis

“…It has been proved to effectively improve the cognitive function, balance ability, lower limb muscle strength and functional physical fitness of the elderly [ 68 ], and prevent the elderly from falling [ 69 ]. Accelerated recovery of physical function and reduced economic costs [ 70 , 71 ] due to the greater emphasis on strength training and balance training. However, compared with other types of training, Otago training pays more attention to fall prevention [ 72 , 73 ], so it may be inferior to other sports in terms of training volume and cannot provide enough stimulation to the body, so the effect is relatively weak.…”

Social Mediators of the Association Between Depression and Falls Among Older Adults

“…Some existing fall prevention approaches include elements of social engagement through group-based exercise programs, by incorporating fall risk evaluation into social service delivery, through health promotion games, or by other means (Dispennette et al, 2019; Goethals et al, 2021; Greenwood-Hickman et al, 2015; Juckett et al, 2021). Mixed evidence suggests that such group-based prevention approaches may be more cost-effective and as or more effective at preventing falls compared to individually focused approaches (Aranda-Reneo et al, 2021; Hayashi et al, 2018; Martin et al, 2013; Sherrington et al, 2017). Still, there is a dearth of research on group-based fall prevention strategies specifically tailored for older adults with mental health issues (Bunn et al, 2014), so the practical benefits of including social components in interventions for older adults with depression remains unclear.…”