Describing the resource utilisation and costs associated withvertebral fractures:​ the build better bones with exercise (B3E) pilot trial

Hassan, S.; Seung, S. J.; Clark, R. E.; Gibbs, J. C.; McArthur, C.; Mittmann, N.; Thabane, L.; Kendler, D.; Papaioannou, A.; Wark, J. D.; Ashe, M. C.; Adachi, J. D.; Templeton, J. A.; Giangregorio, L. M.

Affiliations

¹HOPE Research Centre, Sunnybrook Research Institute, Toronto, Canada

²University of Waterloo, Waterloo, Canada

³McGill University, Montreal, Canada

⁴McMaster University, Hamilton, Canada

⁵Cancer Care Ontario, Toronto, Canada

⁶University of British Columbia, Vancouver, Canada

⁷University of Melbourne, Melbourne, Australia

Abstract and keywords

Summary: This analysis examined costs/resources of 141 women with vertebral fractures, randomised to a home exercise programme or control group. Total, mean costs and the incremental cost-effectiveness ratio (ICER) were calculated. Quality of life was collected. Cost drivers were caregiver time, medications and adverse events (AEs). Results show adding an exercise programme may reduce the risk of AEs.

Introduction: This exploratory economic analysis examined the health resource utilisation and costs experienced by women with vertebral fractures, and explored the effects of home exercise on those costs.

Methods: Women ≥ 65 years with one or more X-ray-confirmed vertebral fractures were randomised 1:1 to a 12-month home exercise programme or equal attention control group. Clinical and health system resources were collected during monthly phone calls and daily diaries completed by participants. Intervention costs were included. Unit costs were applied to health system resources. Quality of life (QoL) information was collected via EQ-5D-5L at baseline, 6 and 12 months.

Results: One hundred and forty-one women were randomised. Overall total costs (CAD 2018) were $664,923 (intervention) and $614,033 (control), respectively. The top three cost drivers were caregiver time ($250,269 and $240,811), medications ($151,000 and $122,145) and AEs ($58,807 and $71,981). The mean cost per intervention participant of $9365 ± $9988 was higher compared with the mean cost per control participant of $8772 ± $9718. The mean EQ-5D index score was higher for the intervention participants (0.81 ± 0.11) compared with that of controls (0.79 ± 0.13). The differences in quality-adjusted life year (QALY) (0.02) and mean cost ($593) were used to calculate the ICER of $29,650.

Conclusions: Women with osteoporosis with a previous fracture experience a number of resources and associated costs that impact their care and quality of life. Caregiver time, medications and AEs are the biggest cost drivers for this population. The next steps would be to expand this feasibility study with more participants, longer-term follow-up and more regional variability.

Keywords: Exercise; Health system costs; Osteoporosis; Resource utilisation; Vertebral fractures

Links

DOI: 10.1007/s00198-020-05387-z

PubMed: 32219499

WoS: 000521857700002

History

Received: 2019-11-22

Accepted: 2020-03-10

Online: 2020-03-26

Cited Works (2)

Year	Entry
2010	Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD; Scientific Advisory Council of Osteoporosis Canada. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. Can Med Assoc J. November 23, 2010;182(17):1864-1873.
1993	Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. September 1993;8(9):1137-1148.

Cited By (1)

Year	Entry
2021	Rodrigues IB. Bridging the Gap Between Physical Activity Evidence and Practice for Older Adults With Osteoporosis and Frailty [PhD thesis]. University of Waterloo; 2021.