Email updates

Keep up to date with the latest news and content from BMC Health Services Research and BioMed Central.

Open Access Research article

An exercise intervention to prevent falls in Parkinson’s: an economic evaluation

Emily Fletcher1, Victoria A Goodwin2, Suzanne H Richards1, John L Campbell1 and Rod S Taylor3*

Author Affiliations

1 Primary Care Research Group, University of Exeter Medical School, Smeall Building, St Luke’s Campus, Magdalen Road, Exeter, EX1 2LU, UK

2 PenCLAHRC, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, EX2 4SG, UK

3 Institute of Health Services Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK

For all author emails, please log on.

BMC Health Services Research 2012, 12:426  doi:10.1186/1472-6963-12-426

Published: 23 November 2012

Abstract

Background

People with Parkinson’s (PwP) experience frequent and recurrent falls. As these falls may have devastating consequences, there is an urgent need to identify cost-effective interventions with the potential to reduce falls in PwP. The purpose of this economic evaluation is to compare the costs and cost-effectiveness of a targeted exercise programme versus usual care for PwP who were at risk of falling.

Methods

One hundred and thirty participants were recruited through specialist clinics, primary care and Parkinson’s support groups and randomised to either an exercise intervention or usual care. Health and social care utilisation and health-related quality of life (EQ-5D) were assessed over the 20 weeks of the study (ten-week intervention period and ten-week follow up period), and these data were complete for 93 participants. Incremental cost per quality adjusted life year (QALY) was estimated. The uncertainty around costs and QALYs was represented using cost-effectiveness acceptability curves.

Results

The mean cost of the intervention was £76 per participant. Although in direction of favour of exercise intervention, there was no statistically significant differences between groups in total healthcare (−£128, 95% CI: -734 to 478), combined health and social care costs (£-35, 95% CI: -817 to 746) or QALYs (0.03, 95% CI: -0.02 to 0.03) at 20 weeks. Nevertheless, exploration of the uncertainty surrounding these estimates suggests there is more than 80% probability that the exercise intervention is a cost-effective strategy relative to usual care.

Conclusion

Whilst we found no difference between groups in total healthcare, total social care cost and QALYs, analyses indicate that there is high probability that the exercise intervention is cost-effective compared with usual care. These results require confirmation by larger trial-based economic evaluations and over the longer term.

Keywords:
Economic evaluation; Cost effectiveness; Parkinson’s; Falls prevention; Rehabilitation