TY  - JOUR
PY  - 2021//
TI  - Cost-effectiveness of a group vs individually delivered exercise program in community-dwelling persons aged ≥70 years
JO  - Journal of the American Medical Directors Association
A1  - Gottschalk, Sophie
A1  - König, Hans-Helmut
A1  - Schwenk, Michael
A1  - Nerz, Corinna
A1  - Becker, Clemens
A1  - Klenk, Jochen
A1  - Jansen, Carl-Philipp
A1  - Dams, Judith
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVES: Interventions aimed at reducing falls and physical inactivity could alleviate the economic burden attributable to these factors. The study aimed to analyze the cost-effectiveness of a group-delivered version of the Lifestyle-integrated Functional Exercise Program compared with an individually delivered program version. <br><br>DESIGN: An economic evaluation conducted alongside the LiFE-is-LiFE randomized non-inferiority trial. INTERVENTIONS: Group and individually delivered version of a program consisting of strength and balance exercises integrated into everyday activities to prevent falls. SETTING AND PARTICIPANTS: 309 community-dwelling older adults (aged ≥70 years) at risk of falling recruited around Heidelberg and Stuttgart (Germany). <br><br>METHODS: Cost-effectiveness of the group program was assessed over 6 months using different effect measures [quality-adjusted life years (QALYs, EQ-5D-5L), physical activity (mean number of steps/day), and falls] and cost perspectives (societal and payer's). Incremental cost-effectiveness ratios were determined, and cost-effectiveness acceptability curves were constructed. <br><br>RESULTS: From a societal perspective, mean costs and QALYs were almost identical between the 2 interventions, and the number of falls was somewhat higher in the group program. From the payer's perspective, the incremental cost-effectiveness ratio for the group compared to the individual program were €56,733 per QALY and €4755 per fall prevented. Based on the cost-effectiveness acceptability curves, the cost-effectiveness of the group program had to be rated as uncertain for both effect measures and perspectives. In contrast, it demonstrated cost-effectiveness for increasing physical activity at willingness-to-pay values per additional 1000 steps/day of €1600 (societal perspective) or €600 (payer's perspective). <br><br>CONCLUSIONS AND IMPLICATIONS: Compared to the individual program, the group program might be cost-effective for increasing physical activity in older adults but was unlikely to be cost-effective with regard to QALY or for preventing falls. The cost-effectiveness should be evaluated long-term and compared to a regular care group.<p />  <p>Language: en</p>
LA  - en
SN  - 1525-8610
UR  - http://dx.doi.org/10.1016/j.jamda.2021.08.041
ID  - ref1
ER  -