A1 Journal article (refereed)
Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons : Randomized Controlled Trial (2021)


Suikkanen, S. A., Soukkio, P. K., Aartolahti, E. M., Kautiainen, H., Kääriä, S. M., Hupli, M. T., Sipilä, S., Pitkälä, K. H., & Kukkonen-Harjula, K. T. (2021). Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons : Randomized Controlled Trial. Journal of the American Medical Directors Association, 22(4), 773-779. https://doi.org/10.1016/j.jamda.2020.06.005


JYU authors or editors


Publication details

All authors or editors: Suikkanen, Sara A.; Soukkio, Paula K.; Aartolahti, Eeva M.; Kautiainen, Hannu; Kääriä, Sanna M.; Hupli, Markku T.; Sipilä, Sarianna; Pitkälä, Kaisu H.; Kukkonen-Harjula, Katriina T.

Journal or series: Journal of the American Medical Directors Association

ISSN: 1525-8610

eISSN: 1538-9375

Publication year: 2021

Volume: 22

Issue number: 4

Pages range: 773-779

Publisher: Elsevier BV

Publication country: United States

Publication language: English

DOI: https://doi.org/10.1016/j.jamda.2020.06.005

Publication open access: Not open

Publication channel open access:

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/74951


Abstract

Objectives
Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study the effects of home-based physical exercise on the number of days spent at home among pre-frail and frail persons, versus usual care. In addition, utilization and costs of health care and social services, cost-effectiveness, and health-related quality-of-life (HRQoL) were explored.

Design
Randomized controlled trial, with year-long supervised exercise for 60 minutes twice a week versus usual care. Follow-up for 24 months after randomization.

Setting and Participants
A sample of 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: ≥65 years, meeting at least 1 of the frailty phenotype criteria, Mini-Mental State Examination score ≥17.

Methods
Primary outcome, days spent at home over 24 months, was calculated deducting days in inpatient care, in nursing homes, and days after death. HRQoL was assessed (15D questionnaire) at baseline and at 3, 6, and 12 months. Utilization data were retrieved from medical records.

Results
The participants' mean age was 82.5 (SD 6.3), 75% were women, 61% were pre-frail and 39% frail. After 24 months, there was no difference between groups in days spent at home [incidence rate ratio 1.03; 95% confidence interval (CI) 0.98–1.09]. After 12 months, the costs per person-year were 1.60-fold in the exercise group (95% CI 1.23–1.98), and after 24 months, 1.23-fold (95% CI 0.95–1.50) versus usual care. Over 12 months, the exercise group gained 0.04 quality-adjusted life-years and maintained the baseline 15D level, while the score in the usual care group deteriorated (P for group <.001, time 0.002, interaction 0.004).

Conclusions and Implications
Physical exercise did not increase the number of days spent at home. Exercise prevented deterioration of HRQoL, and in the frail subgroup, all intervention costs were compensated with decreased utilization of other health care and social services over 24 months.


Keywords: physical activeness; physical training; older people; elderly; home care; institutional care; social services; health services; cost effectiveness

Free keywords: frailty; exercise cost-effectiveness; utilization of social and healthcare services


Contributing organizations


Ministry reporting: Yes

Reporting Year: 2021

Preliminary JUFO rating: 2


Last updated on 2022-17-06 at 11:22