TY  - JOUR
PY  - 2022//
TI  - Economic evaluations of fall prevention exercise programs: a systematic review
JO  - British journal of sports medicine
A1  - Pinheiro, Marina B.
A1  - Sherrington, Catherine
A1  - Howard, Kirsten
A1  - Caldwell, Patrick
A1  - Tiedemann, Anne
A1  - Wang, Belinda
A1  - S Oliveira, Juliana
A1  - Santos, Andreia
A1  - Bull, Fiona C.
A1  - Willumsen, Juana F.
A1  - Michaleff, Zoe A.
A1  - Ferguson, Sarah
A1  - Mayo, Eleesheva
A1  - Fairhall, Nicola J.
A1  - Bauman, Adrian E.
A1  - Norris, Sarah
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: To investigate cost-effectiveness and costs of fall prevention exercise programmes for older adults. <br><br>DESIGN: Systematic review. DATA SOURCES: Medline, Embase, Web of Science, Scopus, National Institute for Health Research Economic Evaluation Database, Health Technology Assessment database, Tufts Cost-Effectiveness Analysis Registry, Research Papers in Economics and EconLit (inception to May 2022).     ELIGIBILITY CRITERIA FOR STUDY SELECTION: Economic evaluations (trial-based or model-based) and costing studies investigating fall prevention exercise programmes versus no intervention or usual care for older adults living in the community or care facilities, and reporting incremental cost-effectiveness ratio (ICER) for fall-related outcomes or quality-adjusted life years (QALY, expressed as cost/QALY) and/or intervention costs. <br><br>RESULTS: 31 studies were included. For community-dwelling older adults (21 economic evaluations, 6 costing studies), results ranged from more effective and less costly (dominant) interventions up to an ICER of US$279 802/QALY gained and US$11 986/fall prevented (US$ in 2020). Assuming an arbitrary willingness-to-pay threshold (US$100 000/QALY), most results (17/24) were considered cost-effective (moderate certainty). The greatest value for money (lower ICER/QALY gained and fall prevented) appeared to accrue for older adults and those with high fall risk, but unsupervised exercise appeared to offer poor value for money (higher ICER/QALY). For care facilities (two economic evaluations, two costing studies), ICERs ranged from dominant (low certainty) to US$35/fall prevented (moderate certainty). Overall, intervention costs varied and were poorly reported. <br><br>CONCLUSIONS: Most economic evaluations investigated fall prevention exercise programmes for older adults living in the community. There is moderate certainty evidence that fall prevention exercise programmes are likely to be cost-effective. The evidence for older adults living in care facilities is more limited but promising.     PROSPERO REGISTRATION NUMBER: PROSPERO 2020 CRD42020178023.<p />  <p>Language: en</p>
LA  - en
SN  - 0306-3674
UR  - http://dx.doi.org/10.1136/bjsports-2022-105747
ID  - ref1
ER  -