A Systematic Review of Economic Evaluations of Fall Prevention Interventions for Community-Dwelling Older People

A Systematic Review of Economic Evaluations of Fall Prevention Interventions for Community-Dwelling Older People

The purpose of this article was to identify the best cost-effective fall prevention measures for 65-year-old and older community-dwelling older adults. Eligibility criteria included being 65 or older, residing in the community, experiencing primary or recurrent falls, and evaluating the cost-effectiveness of any fall prevention intervention. Web of Science, National Institute for Health and Care Excellence Compliance Database, Cinahl Plus, Ovid (Medline), PubMed, ProQuest, Wiley Online, National Health Services Economic Evaluation Databases, EBSCOhost, and PubMed databases were scanned for this study. The risk of bias in cost-effectiveness study reviews was assessed using the Consensus Health Economics Criteria checklist and the Review Manager software. Thus, twenty-two studies met the inclusion criteria (multifactorial program: 12, exercises program: 6, home assessment program: 3, vitamin D supplement: 1). Analyzing those research results, it was revealed that preventive interventions were cost-effective, cost-saving, or cost-beneficial in 17 of them. The Falls Rehabilitation Program, the Home Hazard Reduction Program, and the Community-Based Interventions Targeting Falls Prevention were identified as net cost savings in studies suggesting the assessment of treatments.

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  • Burns, E. R., Stevens, J. A., & Lee, R. (2016). The direct costs of fatal and non-fatal falls among older adults-United States. Journal of Safety Research, 58, 99-103. https://doi.org/10.1016/j.jsr.2016.05.001
  • Cameron, D., Ubels, J., & Norström, F. (2018). On what basis are medical cost-effectiveness thresholds set? Clashing opinions and an absence of data: A systematic review. Global Health Action, 11(1), 1447828. https://doi.org/10.1080/16549716.2018.1447828
  • Davis, J. C., Robertson, M. C., Ashe, M. C., Liu-Ambrose, T., Khan, K. M., & Marra, C. A. (2010). International comparison of cost of falls in older adults living in the community: A systematic review. Osteoporosis International, 21(8), 1295-1306. https://doi.org/10.1007/s00198-009-1162-0
  • Drummond, M., Sculpher, M., Torrance, G., O'Brien, B., & Stoddart, G. (2005). Critical assessment of economic evaluation. In M. F. Drummond, M. J. Sculpher, G. W. Torrance, B. J. O'Brien, & G. L. Stoddart (Eds.), Methods for the Economic Evaluation of Health Care Programmes (3 ed., pp. 27-51). Oxford University Press.
  • Evers, S., Goossens, M., de Vet, H., van Tulder, M., & Ament, A. (2005). Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria. International Journal of Technology Assessment in Health Care, 21(2), 240-245. https://doi.org/10.1017/S0266462305050324
  • Gomersall, J. S., Jadotte, Y. T., Xue, Y., Lockwood, S., Riddle, D., & Preda, A. (2015). Conducting systematic reviews of economic evaluations. International Journal of Evidence-Based Healthcare, 13(3), 170-178. https://doi.org/10.1097/XEB.0000000000000063
  • Hamberg-van Reenen, H. H., Proper, K. I., & van den Berg, M. (2012). Worksite mental health interventions: A systematic review of economic evaluations. Occupational and Environmental Medicine, 69(11), 837-845. https://doi.org/10.1136/oemed-2012-100668
  • Health Committee of the UK Parliament (2012). Written evidence from Karl Claxton, Steve Martin, Marta Soares, Nigel Rice, Eldon Spackman, Sebastian Hinde, Peter C Smith and Mark Sculpher (NICE 61). Retrieved 01.11.2022 from https://publications.parliament.uk/pa/cm201213/cmselect/cmhealth/782/782vw55.htm
  • Hoffman, G. J., Hays, R. D., Shapiro, M. F., Wallace, S. P., & Ettner, S. L. (2016). The costs of fall-related injuries among older adults: Annual per-faller, service component, and patient out-of-pocket costs. Health Services Research, September(1), 20-30. https://doi.org/10.1111/1475-6773.12554
  • Husereau, D., Drummond, M., Petrou, S., Carswell, C., Moher, D., Greenberg, D., Augustovski, F., Briggs, A. H., Mauskopf, J., Loder, E., & CHEERS Task Force. (2013). Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. International Journal of Technology Assessment in Health Care, 29(2), 117-122. https://doi.org/10.1017/S0266462313000160
  • Isaranuwatchai, W., Perdrizet, J., Markle-Reid, M., & Hoch, J. S. (2017). Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling. BMC Geriatrics, 17(1), 199. https://doi.org/10.1186/s12877-017-0599-9
  • Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of Internal Medicine, 151(4), W-65-W-94. https://doi.org/10.7326/0003-4819-151-4-200908180-00136
  • Lim, S. C. (2010). Elderly fallers: What do we need to do? Proceedings of Singapore Healthcare, 19(2), 154-158.
  • Matchar, D. B., Eom, K., Duncan, P. W., Lee, M., Sim, R., Sivapragasam, N. R., Lien, C. T., & Ong, M. E. H. (2019). A Cost-Effectiveness Analysis of a Randomized Control Trial of a Tailored, Multifactorial Program to Prevent Falls Among the Community-Dwelling Elderly. Archives of Physical Medicine and Rehabilitation, 100(1), 1-8. https://doi.org/10.1016/j.apmr.2018.07.434
  • Munn, Z., Moola, S., Lisy, K., Riitano, D., & Tufanaru, C. (2017). Chapter 5: Systematic reviews of prevalence and incidence. In E. Aromataris & Z. Munn (Eds.), JBI Manual for Evidence Synthesis. JBI, 2020. https://doi.org/10.46658/JBIMES-20-06
  • Neumann, P. J., Cohen, J. T., & Weinstein, M. C. (2014). Updating cost-effectiveness: The curious resilience of the $50,000-per-qaly threshold. New England Journal of Medicine, 371(9), 796-797. https://doi.org/10.1056/NEJMp1405158
  • Olij, B. F., Ophuis, R. H., Polinder, S., van Beeck, E. F., Burdorf, A., Panneman, M. J. M., & Sterke, C. S. (2018). Economic Evaluations of Falls Prevention Programs for Older Adults: A Systematic Review. Journal of the American Geriatrics Society, 66(11), 2197-2204. https://doi.org/10.1111/jgs.15578
  • Ruger, J. P., Ruger, J. P., & Emmons, K. M. (2008). Economic evaluations of smoking cessation and relapse prevention programs for pregnant women: A systematic review. Value in Health, 11(2), 180-190.
  • Thielen, F. W., Van Mastrigt, G. A. P. G., Burgers, L. T., Bramer, W. M., Majoie, H., Evers, S., & Kleijnen, J. (2016). How to prepare a systematic review of economic evaluations for clinical practice guidelines: Database selection and search strategy development (part 2/3). Expert Review of Pharmacoeconomics and Outcomes Research, 16(6), 705-721. https://doi.org/10.1080/14737167.2016.1246962
  • van Mastrigt, G. A. P. G., Hiligsmann, M., Arts, J. J. C., Broos, P. H., Kleijnen, J., Evers, S. M. A. A., & Majoie, M. H. J. M. (2016). How to prepare a systematic review of economic evaluations for informing evidence-based healthcare decisions: A five-step approach (part 1/3). Expert Review of Pharmacoeconomics and Outcomes Research, 16(6), 689-704. https://doi.org/10.1080/14737167.2016.1246960
  • Wijnen, B., Van Mastrigt, G., Redekop, W., Majoie, H., De Kinderen, R., & Evers, S. M. A. A. (2016). How to prepare a systematic review of economic evaluations for informing evidence-based healthcare decisions: Data extraction, risk of bias, and transferability (part 3/3). Expert Review of Pharmacoeconomics and Outcomes Research, 16(6), 723-732. https://doi.org/10.1080/14737167.2016.1246961
  • Winser, S., Lee, S. H., Law, H. S., Leung, H. Y., Bello, U. M., & Kannan, P. (2020). Economic evaluations of physiotherapy interventions for neurological disorders: a systematic review. Disability and Rehabilitation, 42(7), 892-901. https://doi.org/10.1080/09638288.2018.1510993
  • World Health Organization (2007). WHO Global report on falls Prevention in older Age. World Health Organization. https://extranet.who.int/agefriendlyworld/wp-content/uploads/2014/06/WHo-Global-report-on-falls-prevention-in-older-age.pdf