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Cost-Effectiveness of a Group vs Individually Delivered Exercise Program in Community-Dwelling Persons Aged ≥70 Years

Cost-Effectiveness of a Group vs Individually Delivered Exercise Program in Community-Dwelling Persons Aged ≥70 Years

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GOTTSCHALK, Sophie, Hans-Helmut KÖNIG, Michael SCHWENK, Corinna NERZ, Clemens BECKER, Jochen KLENK, Carl-Philipp JANSEN, Judith DAMS, 2022. Cost-Effectiveness of a Group vs Individually Delivered Exercise Program in Community-Dwelling Persons Aged ≥70 Years. In: Journal of the American Medical Directors Association. Elsevier. 23(5), pp. 736-742.e6. ISSN 1525-8610. eISSN 1538-9375. Available under: doi: 10.1016/j.jamda.2021.08.041

@article{Gottschalk2022CostE-58316, title={Cost-Effectiveness of a Group vs Individually Delivered Exercise Program in Community-Dwelling Persons Aged ≥70 Years}, year={2022}, doi={10.1016/j.jamda.2021.08.041}, number={5}, volume={23}, issn={1525-8610}, journal={Journal of the American Medical Directors Association}, pages={736--742.e6}, author={Gottschalk, Sophie and König, Hans-Helmut and Schwenk, Michael and Nerz, Corinna and Becker, Clemens and Klenk, Jochen and Jansen, Carl-Philipp and Dams, Judith} }

Gottschalk, Sophie eng 2022-08-17T12:41:49Z Schwenk, Michael 2022 Klenk, Jochen König, Hans-Helmut Schwenk, Michael Jansen, Carl-Philipp Dams, Judith Dams, Judith Gottschalk, Sophie terms-of-use Jansen, Carl-Philipp Becker, Clemens Nerz, Corinna 2022-08-17T12:41:49Z Nerz, Corinna Klenk, Jochen König, Hans-Helmut Cost-Effectiveness of a Group vs Individually Delivered Exercise Program in Community-Dwelling Persons Aged ≥70 Years Becker, Clemens Objectives<br />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<br />An economic evaluation conducted alongside the LiFE-is-LiFE randomized non-inferiority trial.<br /><br />Interventions<br />Group and individually delivered version of a program consisting of strength and balance exercises integrated into everyday activities to prevent falls.<br /><br />Setting and participants<br />309 community-dwelling older adults (aged ≥70 years) at risk of falling recruited around Heidelberg and Stuttgart (Germany).<br /><br />Methods<br />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<br />From a societal perspective, mean costs, the number of falls, and the number of steps/day were somewhat higher in the group program, whereas QALYs were almost identical between the 2 interventions. 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<br />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.

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