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

Prev Chronic Dis. 2015 Jul 30;12:E120. doi: 10.5888/pcd12.140413.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Trial registration: ClinicalTrials.gov NCT00611481.

Publication types

  • Observational Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data
  • Adult
  • Aged
  • Aged, 80 and over
  • Community Health Services
  • Cost-Benefit Analysis*
  • Follow-Up Studies
  • Health Promotion / economics*
  • Health Promotion / methods
  • Health Status
  • Humans
  • Middle Aged
  • Muscle Stretching Exercises / economics
  • Muscle Stretching Exercises / methods
  • Oregon / epidemiology
  • Parkinson Disease / complications*
  • Parkinson Disease / pathology
  • Parkinson Disease / therapy
  • Patient Acceptance of Health Care
  • Postural Balance / physiology
  • Quality-Adjusted Life Years*
  • Resistance Training / economics
  • Resistance Training / methods
  • Self Report
  • Sensitivity and Specificity
  • Surveys and Questionnaires
  • Tai Ji / economics*
  • Tai Ji / methods
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT00611481