sábado, 8 de agosto de 2015

Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008–2011

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Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008–2011

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Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008–2011

Fuzhong Li, PhD; Peter Harmer, PhD, MPH

Suggested citation for this article: Li F, Harmer P. Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008–2011. Prev Chronic Dis 2015;12:140413. DOI: http://dx.doi.org/10.5888/pcd12.140413.


Exercise is effective in reducing falls in people with Parkinson disease. However, information on the cost effectiveness of this approach is lacking. We conducted a cost-effectiveness analysis of Tai Ji Quan for reducing falls among patients with mild-to-moderate Parkinson disease.
We used data from a previous intervention trial to analyze resource use costs related to intervention delivery and number of falls observed during a 9-month study period. Cost effectiveness was estimated via incremental cost-effectiveness ratio (ICER) in which Tai Ji Quan was compared with 2 alternative interventions (Resistance training and Stretching) on the primary outcome of per fall prevented and the secondary outcome of per participant quality-adjusted life years (QALY) gained. We also conducted subgroup and sensitivity analyses.
Tai Ji Quan was more effective than either Resistance training or Stretching; it had the lowest cost and was the most effective in improving primary and secondary outcomes. Compared with Stretching, Tai Ji Quan cost an average of $175 less for each additional fall prevented and produced a substantial improvement in QALY gained at a lower cost. Results from subgroup and sensitivity analyses showed no variation in cost-effectiveness estimates. However, sensitivity analyses demonstrated a much lower ICER ($27) when only intervention costs were considered.
Tai Ji Quan represents a cost-effective strategy for optimizing spending to prevent falls and maximize health gains in people with Parkinson disease. While these results are promising, they warrant further validation.


The work reported in this article was supported by grants (NS047130, AG045094) from the National Institute of Neurological Disorders and Stroke and the National Institute on Aging. The authors report no conflict of interests. Trial registration (clinicaltrials.gov) identifier: NCT00611481.

Author Information

Corresponding Author: Fuzhong Li, PhD, Oregon Research Institute, 1776 Millrace Dr, Eugene, OR 97403. Email: fuzhongl@ori.org.
Author Affiliation: Peter Harmer, Willamette University, Salem, Oregon.


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