Citation

Irvine L, Conroy SP, Sach TH, Gladman JRF, Harwood RH, Kendrick D, Coupland CAC, Drummond A, Barton G, Masud T. Age Ageing 2010; 39(6): 710-716.

Affiliation

School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK.

Copyright

(Copyright © 2010, Oxford University Press)

DOI

10.1093/ageing/afq108

PMID

20833862

PMCID

PMC2956532

Abstract

BACKGROUND: multifactorial falls prevention programmes for older people have been proved to reduce falls. However, evidence of their cost-effectiveness is mixed. DESIGN: economic evaluation alongside pragmatic randomised controlled trial. Intervention: randomised trial of 364 people aged ≥70, living in the community, recruited via GP and identified as high risk of falling. Both arms received a falls prevention information leaflet. The intervention arm were also offered a (day hospital) multidisciplinary falls prevention programme, including physiotherapy, occupational therapy, nurse, medical review and referral to other specialists. MEASUREMENTS: self-reported falls, as collected in 12 monthly diaries. Levels of health resource use associated with the falls prevention programme, screening (both attributed to intervention arm only) and other health-care contacts were monitored. Mean NHS costs and falls per person per year were estimated for both arms, along with the incremental cost-effectiveness ratio (ICER) and cost effectiveness acceptability curve. RESULTS: in the base-case analysis, the mean falls programme cost was £349 per person. This, coupled with higher screening and other health-care costs, resulted in a mean incremental cost of £578 for the intervention arm. The mean falls rate was lower in the intervention arm (2.07 per person/year), compared with the control arm (2.24). The estimated ICER was £3,320 per fall averted. CONCLUSIONS: the estimated ICER was £3,320 per fall averted. Future research should focus on adherence to the intervention and an assessment of impact on quality of life.

Language: en