@article{ref1,
title="Dosage for cost-effective exercise-based falls prevention programs for older people: a systematic review of economic evaluations",
journal="Annals of physical and rehabilitation medicine",
year="2019",
author="Winser, Stanley John and Fion, Chan Hei Tung and Ho, Lam and Chung, Lau Sze and Ching, Lau Tsz and Felix, Tom Kin Lok and Kannan, Priya",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Falls in older people is a global public health concern. Physical exercise is a useful and potentially cost-saving treatment option to prevent falls in older people. <br><br>OBJECTIVES: We aimed to 1) summarize the research literature regarding the cost-effectiveness of exercise-based programs for falls prevention in older people and 2) discuss the implications of the review's findings for clinical practice and future research on the dosage of cost-effective exercise-based falls prevention programs for older people. <br><br>METHODS: Multiple databases were searched from inception until February 2019. Studies were included if they 1) were randomized controlled trials with an economic evaluation of exercise-based falls prevention programs for people ≥ 60 years old and 2) assessed the incremental cost-effectiveness ratios, cost per quality-adjusted life year, incremental cost per fall and benefit-to-cost ratio of programs. <br><br>METHODological quality was assessed with the Physiotherapy Evidence Database scale and quality of economic evaluation with the Quality of Health Economic Studies. <br><br>RESULTS: We included 12 studies (3668 older people). Interventions for falls prevention were either exercise-only or multifactorial programs. Five studies of high economic quality and 2 of high methodological quality provided evidence supporting exercise-only programs as cost-effective for preventing falls in older people. Specifically, a tailored exercise program including strengthening of lower extremities, balance training, cardiovascular exercise, stretching and functional training of moderate intensity performed twice per week with each session lasting 60 min for ≥ 6 months delivered in groups of 3 to 8 participants with home-based follow-up appears to be cost-effective in preventing falls in older people. <br><br>CONCLUSION: There is evidence to support exercise-based interventions as cost-effective treatment for preventing falls. Further research is needed to fully establish the cost-effectiveness of such programs, especially in both developing and underdeveloped countries.<br><br>Copyright © 2019. Published by Elsevier Masson SAS.<p /> <p>Language: en</p>",
language="en",
issn="1877-0657",
doi="10.1016/j.rehab.2019.06.012",
url="http://dx.doi.org/10.1016/j.rehab.2019.06.012"
}