Abstract
BackgroundOomph! Wellness organises interactive exercise and activity classes (Oomph! classes) for older people in care homes. We investigated the cost-effectiveness of Oomph! classes.MethodsHealth-related quality of life was measured using the EQ-5D-5 L questionnaire at three time points; 3 months and 1 week prior to the start of the classes and after 3 months of Oomph! classes. Costs included the costs of organising the classes, training instructors and health service use (General Practitioner (GP) and hospital outpatient visits). To determine the cost-effectiveness of Oomph! classes, total costs and quality-adjusted life-years (QALYs) during the 3 months after initiation of the classes were compared to the total costs and QALYs of the 3 months prior to the classes and extrapolated to a 1-year time horizon. Uncertainty was taken into account using one-way and probabilistic sensitivity analysis.ResultsSixteen residents completed all three EQ-5D-5 L questionnaires. There was a decrease in mean health related quality of life per participant in the 3 months before Oomph! classes (0.56 to 0.52, p = 0.26) and an increase in the 3 months after the start of Oomph! classes (0.52 to 0.60, p = 0.06), but the changes were not statistically significant. There were more GP visits after the start of Oomph! classes and fewer hospital outpatient visits, leading to a slight decrease in NHS costs (mean £132 vs £141 per participant), but the differences were not statistically significant (p = 0.79). In the base case scenario, total costs for Oomph! classes were £113 higher per participant than without Oomph! classes (£677 vs £564) and total QALYs were 0.074 higher (0.594 vs 0.520). The incremental costs per QALY gained were therefore £1531. The 95 % confidence intervals around the cost/QALY gained varied from dominant to dominated, meaning there was large uncertainty around the cost-effectiveness results. Given a willingness to pay threshold of £20,000 per QALY gained, Oomph! classes had a 62 %–86 % probability of being cost-effective depending on the scenario used.ConclusionsPreliminary evidence suggests that Oomph! classes may be cost-effective, but further evidence is needed about its impact on health-related quality of life and health service use.
Highlights
Oomph! Wellness organises interactive exercise and activity classes (Oomph! classes) for older people in care homes
There were 16 residents who completed all three EQ-5D-5 L questionnaires, and we used these for our base case analysis
We did not have information on General Practitioner (GP)/hospital visits before and after Oomph! classes for all 16 participants who were included in the analysis of health related quality of life
Summary
Oomph! Wellness organises interactive exercise and activity classes (Oomph! classes) for older people in care homes. Wellness organises interactive exercise and activity classes Classes) for older people in care homes. A recent study among older care home residents in the UK found that care home residents spent on average 79 % of their day as sedentary, 14 % in low, 6 % in light, and 1 % in moderate-tovigorous physical activity [2]. In addition to low levels of physical activity, care home residents often have a lack of meaningful social interaction [3]. Regular exercise can improve physical function of frail older people [4]. If exercise training is combined with cognitive training, it can improve functional status as well as cognitive function in older adults with and without cognitive impairment [5]. Exercise—and wider meaningful activities—can be a tool for building and cementing relationships, improving alertness and involvement, increasing confidence and creating a sense of wellbeing
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