Citation

Evers SM, Dorresteijn TA, Wijnen BF, van Haastregt JC, Kempen GI, Zijlstra GR. Expert Rev. Pharmacoecon. Outcomes Res. 2019; ePub(ePub): ePub.

Affiliation

Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , the Netherlands.

Copyright

(Copyright © 2019, Expert Reviews)

DOI

10.1080/14737167.2019.1666714

PMID

31502897

Abstract

Background Concerns about falls, or fear of falling, are frequently reported by older people and can have serious consequences. Aim of this study was to evaluate the cost-effectiveness of a home-based, cognitive behavioural programme for independently-living, frail older people in comparison with usual care from a societal perspective.

METHODS This economic evaluation was embedded in a randomised-controlled trial with a follow-up of 12-months. In the trial 389 people aged 70 years or older were allocated to usual care (n=195) or the intervention group (n=194). The intervention group received a home-based, cognitive behavioural programme. Main outcome measures were concerns about falls and Quality Adjusted Life Years (QALYs).

RESULTS Average total costs per participant in the usual care group were 8,094 Euros and 7,890 Euros for participants in the intervention group. The intervention group showed a significant decrease in concerns about falls and a non-significant increase in QALYS in comparison with the usual care group. The probability that the intervention was cost-effective was 75% at a willingness to pay of 20,000 Euros per QALY.

DISCUSSION The programme is likely to be cost-effective, and therefore a useful addition to current geriatric care, particularly for those persons who are not able or willing to attend group programmes. Trial registration: NCT01358032.

Language: en

Keywords

accidental falls; aged; avoidance behaviour; cognitive behavioural therapy; economic evaluation; fear of falling; quality adjusted life years; randomised controlled trial