Cost effectiveness of a community based exercise programme in over 65 year olds

Cluster randomised trial

James F. Munro, Jon P. Nicholl, John E. Brazier, Rachel Davey, Tom Cochrane

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Objective: To assess the cost effectiveness of a community based exercise programme as a population wide public health intervention for older adults. Design: Pragmatic, cluster randomised community intervention trial. Setting: 12 general practices in Sheffield; four randomly selected as intervention populations, and eight as control populations. Participants: All those aged 65 and over in the least active four fifths of the population responding to a baseline survey. There were 2283 eligible participants from intervention practices and 4137 from control practices. Intervention: Eligible subjects were invited to free locally held exercise classes, made available for two years. Main outcome measures: All cause and exercise related cause specific mortality and hospital service use at two years, and health status assessed at baseline, one, and two years using the SF-36. A cost utility analysis was also undertaken. Results: Twenty six per cent of the eligible intervention practice population attended one or more exercise sessions. There were no significant differences in mortality rates, survival times, or admissions. After adjusting for baseline characteristics, patients in intervention practices had a lower decline in health status, although this reached significance only for the energy dimension and two composite scores (p<0.05). The incremental average QALY gain of 0.011 per person in the intervention population resulted in an incremental cost per QALY ratio of €17 174 (95% CI = €8300 to €87 120). Conclusions: Despite a low level of adherence to the exercise programme, there were significant gains in health related quality of life. The programme was more cost effective than many existing medical interventions, and would be practical for primary care commissioning agencies to implement.

Original languageEnglish
Pages (from-to)1004-1010
Number of pages7
JournalJournal of Epidemiology and Community Health
Volume58
Issue number12
DOIs
Publication statusPublished - Dec 2004
Externally publishedYes

Fingerprint

Cost-Benefit Analysis
Exercise
Population
Quality-Adjusted Life Years
Health Status
Costs and Cost Analysis
Hospital Mortality
General Practice
Primary Health Care
Public Health
Quality of Life
Outcome Assessment (Health Care)
Survival
Mortality

Cite this

Munro, James F. ; Nicholl, Jon P. ; Brazier, John E. ; Davey, Rachel ; Cochrane, Tom. / Cost effectiveness of a community based exercise programme in over 65 year olds : Cluster randomised trial. In: Journal of Epidemiology and Community Health. 2004 ; Vol. 58, No. 12. pp. 1004-1010.
@article{eb893f435c494b3f8c7b74f689baef9d,
title = "Cost effectiveness of a community based exercise programme in over 65 year olds: Cluster randomised trial",
abstract = "Objective: To assess the cost effectiveness of a community based exercise programme as a population wide public health intervention for older adults. Design: Pragmatic, cluster randomised community intervention trial. Setting: 12 general practices in Sheffield; four randomly selected as intervention populations, and eight as control populations. Participants: All those aged 65 and over in the least active four fifths of the population responding to a baseline survey. There were 2283 eligible participants from intervention practices and 4137 from control practices. Intervention: Eligible subjects were invited to free locally held exercise classes, made available for two years. Main outcome measures: All cause and exercise related cause specific mortality and hospital service use at two years, and health status assessed at baseline, one, and two years using the SF-36. A cost utility analysis was also undertaken. Results: Twenty six per cent of the eligible intervention practice population attended one or more exercise sessions. There were no significant differences in mortality rates, survival times, or admissions. After adjusting for baseline characteristics, patients in intervention practices had a lower decline in health status, although this reached significance only for the energy dimension and two composite scores (p<0.05). The incremental average QALY gain of 0.011 per person in the intervention population resulted in an incremental cost per QALY ratio of €17 174 (95{\%} CI = €8300 to €87 120). Conclusions: Despite a low level of adherence to the exercise programme, there were significant gains in health related quality of life. The programme was more cost effective than many existing medical interventions, and would be practical for primary care commissioning agencies to implement.",
author = "Munro, {James F.} and Nicholl, {Jon P.} and Brazier, {John E.} and Rachel Davey and Tom Cochrane",
year = "2004",
month = "12",
doi = "10.1136/jech.2003.014225",
language = "English",
volume = "58",
pages = "1004--1010",
journal = "Journal of Epidemiology Community Health",
issn = "0143-005X",
publisher = "BMJ Publishing Group",
number = "12",

}

Cost effectiveness of a community based exercise programme in over 65 year olds : Cluster randomised trial. / Munro, James F.; Nicholl, Jon P.; Brazier, John E.; Davey, Rachel; Cochrane, Tom.

In: Journal of Epidemiology and Community Health, Vol. 58, No. 12, 12.2004, p. 1004-1010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cost effectiveness of a community based exercise programme in over 65 year olds

T2 - Cluster randomised trial

AU - Munro, James F.

AU - Nicholl, Jon P.

AU - Brazier, John E.

AU - Davey, Rachel

AU - Cochrane, Tom

PY - 2004/12

Y1 - 2004/12

N2 - Objective: To assess the cost effectiveness of a community based exercise programme as a population wide public health intervention for older adults. Design: Pragmatic, cluster randomised community intervention trial. Setting: 12 general practices in Sheffield; four randomly selected as intervention populations, and eight as control populations. Participants: All those aged 65 and over in the least active four fifths of the population responding to a baseline survey. There were 2283 eligible participants from intervention practices and 4137 from control practices. Intervention: Eligible subjects were invited to free locally held exercise classes, made available for two years. Main outcome measures: All cause and exercise related cause specific mortality and hospital service use at two years, and health status assessed at baseline, one, and two years using the SF-36. A cost utility analysis was also undertaken. Results: Twenty six per cent of the eligible intervention practice population attended one or more exercise sessions. There were no significant differences in mortality rates, survival times, or admissions. After adjusting for baseline characteristics, patients in intervention practices had a lower decline in health status, although this reached significance only for the energy dimension and two composite scores (p<0.05). The incremental average QALY gain of 0.011 per person in the intervention population resulted in an incremental cost per QALY ratio of €17 174 (95% CI = €8300 to €87 120). Conclusions: Despite a low level of adherence to the exercise programme, there were significant gains in health related quality of life. The programme was more cost effective than many existing medical interventions, and would be practical for primary care commissioning agencies to implement.

AB - Objective: To assess the cost effectiveness of a community based exercise programme as a population wide public health intervention for older adults. Design: Pragmatic, cluster randomised community intervention trial. Setting: 12 general practices in Sheffield; four randomly selected as intervention populations, and eight as control populations. Participants: All those aged 65 and over in the least active four fifths of the population responding to a baseline survey. There were 2283 eligible participants from intervention practices and 4137 from control practices. Intervention: Eligible subjects were invited to free locally held exercise classes, made available for two years. Main outcome measures: All cause and exercise related cause specific mortality and hospital service use at two years, and health status assessed at baseline, one, and two years using the SF-36. A cost utility analysis was also undertaken. Results: Twenty six per cent of the eligible intervention practice population attended one or more exercise sessions. There were no significant differences in mortality rates, survival times, or admissions. After adjusting for baseline characteristics, patients in intervention practices had a lower decline in health status, although this reached significance only for the energy dimension and two composite scores (p<0.05). The incremental average QALY gain of 0.011 per person in the intervention population resulted in an incremental cost per QALY ratio of €17 174 (95% CI = €8300 to €87 120). Conclusions: Despite a low level of adherence to the exercise programme, there were significant gains in health related quality of life. The programme was more cost effective than many existing medical interventions, and would be practical for primary care commissioning agencies to implement.

UR - http://www.scopus.com/inward/record.url?scp=9444226483&partnerID=8YFLogxK

U2 - 10.1136/jech.2003.014225

DO - 10.1136/jech.2003.014225

M3 - Article

VL - 58

SP - 1004

EP - 1010

JO - Journal of Epidemiology Community Health

JF - Journal of Epidemiology Community Health

SN - 0143-005X

IS - 12

ER -