1. Smallest worthwhile effect of exercise programs to prevent falls among older people: estimates from benefit-harm trade-off and discrete choice methods
- Author
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John M. Rose, Marcia R. Franco, Manuela L. Ferreira, Catherine Sherrington, Kirsten Howard, Paulo H. Ferreira, Franco, MR, Howard, K, Sherrington, C, Rose, J, Ferreira, PH, and Ferreira, ML
- Subjects
Gerontology ,Male ,Aging ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Cost-Benefit Analysis ,discrete choice experiment exercise ,Poison control ,Suicide prevention ,Health intervention ,Choice Behavior ,Risk Assessment ,Decision Support Techniques ,older people ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,falls ,Medicine ,Humans ,030212 general & internal medicine ,Patient participation ,Aged ,Geriatrics ,Aged, 80 and over ,Discrete choice ,business.industry ,Process Assessment, Health Care ,General Medicine ,Health Care Costs ,Middle Aged ,benefit–harm trade-off ,Exercise Therapy ,Treatment Outcome ,1103 Clinical Sciences, 1117 Public Health and Health Services, 1701 Psychology ,smallest worthwhile effect ,Accidental Falls ,Female ,Geriatrics and Gerontology ,Patient Participation ,business ,Risk assessment ,030217 neurology & neurosurgery ,Fall prevention - Abstract
BACKGROUND: the smallest worthwhile effect (SWE) of an intervention is the smallest treatment effect that justifies the costs, risks and inconveniences associated with that health intervention. OBJECTIVE: to estimate the SWE of exercise programs designed to prevent falls among older people and to compare estimates derived by two methodological approaches. STUDY DESIGN AND SETTING: discrete choice experiment (n = 220) and benefit-harm trade-off (subsample n = 66) methods were used. PARTICIPANTS: community-dwelling older people who reported a past fall or a mobility limitation answered online or face-to-face questionnaires. RESULTS: a substantial proportion of participants (82% in the discrete choice experiment and 50% in the benefit-harm trade-off study) did not consider that participation in the proposed exercise programs would be worthwhile, even if it reduced their risk of falling to 0%. Among remaining participants, the average SWE of participation in an exercise program was an absolute reduction in the risk of falling of 35% (standard deviation [SD] = 13) in the discrete choice experiment and 16% (SD = 11) in the benefit-harm trade-off study. CONCLUSIONS: many participants did not consider the hypothetical falls' risk reduction of the proposed exercise programs to be worth the associated costs and inconveniences. Greater community awareness of the fall prevention effects of exercise for older people is required.© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: [email protected]/* */ Language: en
- Published
- 2015