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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

Cost-effectiveness acceptability curve. This graph shows for each scenario the probability that Oomph! classes would be cost-effective at different willingness to pay thresholds
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Fig3: Cost-effectiveness acceptability curve. This graph shows for each scenario the probability that Oomph! classes would be cost-effective at different willingness to pay thresholds

Mentions: In the probabilistic sensitivity analysis we found that given a willingness to pay threshold of £20,000 per QALY gained as recommended by the National Institute of Health and Care Excellence (NICE) [11], Oomph! classes have a 76 % probability of being cost-effective in the base case scenario. This probability was 86 % in the best case scenario and 62 % in the worst case scenario. Figure 3 shows a cost-effectiveness acceptability curve, portraying this probability for each scenario at different willingness to pay thresholds.Fig. 3


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)

Cost-effectiveness acceptability curve. This graph shows for each scenario the probability that Oomph! classes would be cost-effective at different willingness to pay thresholds
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Cost-effectiveness acceptability curve. This graph shows for each scenario the probability that Oomph! classes would be cost-effective at different willingness to pay thresholds
Mentions: In the probabilistic sensitivity analysis we found that given a willingness to pay threshold of £20,000 per QALY gained as recommended by the National Institute of Health and Care Excellence (NICE) [11], Oomph! classes have a 76 % probability of being cost-effective in the base case scenario. This probability was 86 % in the best case scenario and 62 % in the worst case scenario. Figure 3 shows a cost-effectiveness acceptability curve, portraying this probability for each scenario at different willingness to pay thresholds.Fig. 3

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