Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial

摘要

Objectives To assess the effectiveness of a trainedrndistrict nurse individually prescribing a home basedrnexercise programme to reduce falls and injuries inrnelderly people and to estimate the cost effectiveness ofrnthe programme.rnDesign Randomised controlled trial with one year'srnfollow up.rnSetting Community health service at a New Zealandrnhospital.rnParticipants 240 women and men aged 75 years andrnolder.rnIntervention 121 participants received the exercisernprogramme (exercise group) and 119 received usualrncare (control group); 90% (211 of 233) completed therntrial.rnMain outcome measures Number of falls, number ofrninjuries resulting from falls, costs of implementing thernprogramme, and hospital costs as a result of falls.rnResults Falls were reduced by 46% (incidence raternratio 0.54, 95% confidence interval 0.32 to 0.90). Fivernhospital admissions were due to injuries caused byrnfalls in the control group and none in the exerciserngroup. The programme cost $NZ1803 (£523) (at 1998rnprices) per fall prevented for delivering thernprogramme and $NZ155 per fall prevented whenrnhospital costs averted were considered.rnConclusion A home exercise programme, previouslyrnshown to be successful when delivered by arnphysiotherapist, was also effective in reducing fallsrnwhen delivered by a trained nurse from within arnhome health service. Serious injuries and hospitalrnadmissions due to falls were also reduced. Thernprogramme was cost effective in participants aged 80rnyears and older compared with younger participants.