Limits...
Cost-effectiveness of a physical exercise programme for residents of care homes: a pilot study.

Verhoef TI, Doshi P, Lehner D, Morris S - BMC Geriatr (2016)

Bottom Line: To determine the cost-effectiveness of Oomph!The 95 % confidence intervals around the cost/QALY gained varied from dominant to dominated, meaning there was large uncertainty around the cost-effectiveness results.classes had a 62 %-86 % probability of being cost-effective depending on the scenario used.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK. t.verhoef@ucl.ac.uk.

ABSTRACT

Background: Oomph! Wellness organises interactive exercise and activity classes (Oomph! classes) for older people in care homes. We investigated the cost-effectiveness of Oomph! classes.

Methods: Health-related quality of life was measured using the EQ-5D-5 L questionnaire at three time points; 3 months and 1 week prior to the start of the classes and after 3 months of Oomph! classes. Costs included the costs of organising the classes, training instructors and health service use (General Practitioner (GP) and hospital outpatient visits). To determine the cost-effectiveness of Oomph! classes, total costs and quality-adjusted life-years (QALYs) during the 3 months after initiation of the classes were compared to the total costs and QALYs of the 3 months prior to the classes and extrapolated to a 1-year time horizon. Uncertainty was taken into account using one-way and probabilistic sensitivity analysis.

Results: Sixteen residents completed all three EQ-5D-5 L questionnaires. There was a decrease in mean health related quality of life per participant in the 3 months before Oomph! classes (0.56 to 0.52, p = 0.26) and an increase in the 3 months after the start of Oomph! classes (0.52 to 0.60, p = 0.06), but the changes were not statistically significant. There were more GP visits after the start of Oomph! classes and fewer hospital outpatient visits, leading to a slight decrease in NHS costs (mean £132 vs £141 per participant), but the differences were not statistically significant (p = 0.79). In the base case scenario, total costs for Oomph! classes were £113 higher per participant than without Oomph! classes (£677 vs £564) and total QALYs were 0.074 higher (0.594 vs 0.520). The incremental costs per QALY gained were therefore £1531. The 95 % confidence intervals around the cost/QALY gained varied from dominant to dominated, meaning there was large uncertainty around the cost-effectiveness results. Given a willingness to pay threshold of £20,000 per QALY gained, Oomph! classes had a 62 %-86 % probability of being cost-effective depending on the scenario used.

Conclusions: Preliminary evidence suggests that Oomph! classes may be cost-effective, but further evidence is needed about its impact on health-related quality of life and health service use.

No MeSH data available.


Related in: MedlinePlus

Scatter plot. These graphs show the incremental costs and incremental QALYs for each simulation of the probabilistic sensitivity analysis. a Base case scenario, (b) Best case scenario, (c) Worst case scenario
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4836064&req=5

Fig2: Scatter plot. These graphs show the incremental costs and incremental QALYs for each simulation of the probabilistic sensitivity analysis. a Base case scenario, (b) Best case scenario, (c) Worst case scenario

Mentions: Incremental costs and QALYs gained were adjusted for age and gender. Total yearly costs per participant were based on 4 times the 3-monthly NHS costs in the control group and 4 times the 3-monthly NHS costs plus costs for Oomph! classes in the intervention group. In the base case scenario, 1-year costs were £113 higher (£677 vs. £564) with Oomph! classes than in the absence of Oomph! classes. QALYs increased by 0.074 (0.594 vs. 0.520) and the incremental costs per QALY gained were therefore £1531. In the best case scenario the incremental costs were the same as in the base case scenario, but incremental QALYs were 0.110 (0.594 vs. 0.483) and the incremental costs per QALY gained were £1021. In the worst case scenario, incremental costs were £140 (£704 vs. £564), incremental QALYs 0.011 (0.531 vs. 0.520) and the incremental costs per QALY gained £13,290. The 95 % confidence intervals around the incremental cost-effectiveness ratio varied from dominant to dominated (Table 5). The large confidence intervals mean there is substantial uncertainty around our cost-effectiveness results. This can also be seen on the scatter plot in Fig. 2, which shows the incremental costs and incremental QALYs for each simulation of the probabilistic sensitivity analysis.Table 5


Cost-effectiveness of a physical exercise programme for residents of care homes: a pilot study.

Verhoef TI, Doshi P, Lehner D, Morris S - BMC Geriatr (2016)

Scatter plot. These graphs show the incremental costs and incremental QALYs for each simulation of the probabilistic sensitivity analysis. a Base case scenario, (b) Best case scenario, (c) Worst case scenario
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4836064&req=5

Fig2: Scatter plot. These graphs show the incremental costs and incremental QALYs for each simulation of the probabilistic sensitivity analysis. a Base case scenario, (b) Best case scenario, (c) Worst case scenario
Mentions: Incremental costs and QALYs gained were adjusted for age and gender. Total yearly costs per participant were based on 4 times the 3-monthly NHS costs in the control group and 4 times the 3-monthly NHS costs plus costs for Oomph! classes in the intervention group. In the base case scenario, 1-year costs were £113 higher (£677 vs. £564) with Oomph! classes than in the absence of Oomph! classes. QALYs increased by 0.074 (0.594 vs. 0.520) and the incremental costs per QALY gained were therefore £1531. In the best case scenario the incremental costs were the same as in the base case scenario, but incremental QALYs were 0.110 (0.594 vs. 0.483) and the incremental costs per QALY gained were £1021. In the worst case scenario, incremental costs were £140 (£704 vs. £564), incremental QALYs 0.011 (0.531 vs. 0.520) and the incremental costs per QALY gained £13,290. The 95 % confidence intervals around the incremental cost-effectiveness ratio varied from dominant to dominated (Table 5). The large confidence intervals mean there is substantial uncertainty around our cost-effectiveness results. This can also be seen on the scatter plot in Fig. 2, which shows the incremental costs and incremental QALYs for each simulation of the probabilistic sensitivity analysis.Table 5

Bottom Line: To determine the cost-effectiveness of Oomph!The 95 % confidence intervals around the cost/QALY gained varied from dominant to dominated, meaning there was large uncertainty around the cost-effectiveness results.classes had a 62 %-86 % probability of being cost-effective depending on the scenario used.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK. t.verhoef@ucl.ac.uk.

ABSTRACT

Background: Oomph! Wellness organises interactive exercise and activity classes (Oomph! classes) for older people in care homes. We investigated the cost-effectiveness of Oomph! classes.

Methods: Health-related quality of life was measured using the EQ-5D-5 L questionnaire at three time points; 3 months and 1 week prior to the start of the classes and after 3 months of Oomph! classes. Costs included the costs of organising the classes, training instructors and health service use (General Practitioner (GP) and hospital outpatient visits). To determine the cost-effectiveness of Oomph! classes, total costs and quality-adjusted life-years (QALYs) during the 3 months after initiation of the classes were compared to the total costs and QALYs of the 3 months prior to the classes and extrapolated to a 1-year time horizon. Uncertainty was taken into account using one-way and probabilistic sensitivity analysis.

Results: Sixteen residents completed all three EQ-5D-5 L questionnaires. There was a decrease in mean health related quality of life per participant in the 3 months before Oomph! classes (0.56 to 0.52, p = 0.26) and an increase in the 3 months after the start of Oomph! classes (0.52 to 0.60, p = 0.06), but the changes were not statistically significant. There were more GP visits after the start of Oomph! classes and fewer hospital outpatient visits, leading to a slight decrease in NHS costs (mean £132 vs £141 per participant), but the differences were not statistically significant (p = 0.79). In the base case scenario, total costs for Oomph! classes were £113 higher per participant than without Oomph! classes (£677 vs £564) and total QALYs were 0.074 higher (0.594 vs 0.520). The incremental costs per QALY gained were therefore £1531. The 95 % confidence intervals around the cost/QALY gained varied from dominant to dominated, meaning there was large uncertainty around the cost-effectiveness results. Given a willingness to pay threshold of £20,000 per QALY gained, Oomph! classes had a 62 %-86 % probability of being cost-effective depending on the scenario used.

Conclusions: Preliminary evidence suggests that Oomph! classes may be cost-effective, but further evidence is needed about its impact on health-related quality of life and health service use.

No MeSH data available.


Related in: MedlinePlus