Effectiveness and cost-effectiveness of offering a chair-based yoga programme in addition to usual care in older adults with multiple long-term conditions: a pragmatic, parallel group, open label, randomised controlled trial

Garry Tew; Laura Wiley; Lesley Ward; Jess Hugill-Jones; Camila Maturana; Caroline Fairhurst; Kerry Bell; Laura Bissell; Alison Booth; Jenny Howsam; Valerie Mount; Tim Rapley; Sarah Ronaldson; Fiona Rose; David Torgerson; David Yates; Catherine Hewitt

doi:10.3310/nihropenres.13465.2

Effectiveness and cost-effectiveness of offering a chair-based yoga programme in addition to usual care in older adults with multiple long-term conditions: a pragmatic, parallel group, open label, randomised controlled trial

NIHR Open Res. 2024 Aug 12:3:52. doi: 10.3310/nihropenres.13465.2. eCollection 2023.

Authors

Garry Tew^{1

2

3}, Laura Wiley², Lesley Ward^{2

3}, Jess Hugill-Jones², Camila Maturana², Caroline Fairhurst², Kerry Bell², Laura Bissell⁴, Alison Booth², Jenny Howsam⁴, Valerie Mount⁵, Tim Rapley⁶, Sarah Ronaldson², Fiona Rose², David Torgerson², David Yates⁷, Catherine Hewitt²

Affiliations

¹ Institute for Health and Care Improvement, York St John University, York, North Yorkshire, YO31 7EX, UK.
² York Trials Unit, University of York, York, North Yorkshire, YO10 5DD, UK.
³ Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, NE1 8SG, UK.
⁴ British Wheel of Yoga Qualifications, Sleaford, Lincolnshire, NG34 7RU, UK.
⁵ Public representative of the Trial Management Group, NA, UK.
⁶ Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, NE1 8SG, UK.
⁷ Department of Anaesthesia, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, YO31 8HE, UK.

Abstract

Background: People with multiple long-term conditions are more likely to have poorer health-related quality of life (HRQOL). Yoga has the potential to improve HRQOL. Gentle Years Yoga© (GYY) is a chair-based yoga programme for older adults. We investigated the effectiveness and cost-effectiveness of the GYY programme in older adults with multiple long-term conditions.

Methods: In this pragmatic, multi-site, open, randomised controlled trial, we recruited adults aged ≥65 years with ≥2 long-term conditions from 15 primary care practices in England and Wales. Participants were randomly assigned to usual care control or a 12-week, group-based, GYY programme delivered face-to-face or online by qualified yoga teachers. The primary outcome was HRQOL (EQ-5D-5L) over 12 months. Secondary outcomes included anxiety, depression, falls, loneliness, healthcare resource use, and adverse events.

Results: Between October 2019 and October 2021, 454 participants were randomised between the intervention (n=240) and control (n=214) groups. Seven GYY courses were delivered face-to-face and 12 courses were delivered online. The mean number of classes attended among all intervention participants was nine (SD 4, median 10). In our intention-to-treat analysis (n=422), there was no statistically significant difference between trial groups in the primary outcome of HRQOL (adjusted difference in mean EQ-5D-5L = 0.020 [favouring intervention]; 95% CI -0.006 to 0.045, p=0.14). There were also no statistically significant differences in key secondary outcomes. No serious, related adverse events were reported. The incremental cost-effectiveness ratio was £4,546 per quality-adjusted life-year (QALY) and the intervention had a 79% probability of being cost-effective at a willingness-to-pay threshold of £20,000 per QALY. The intervention was acceptable to most participants and perceived as useful by some.

Conclusions: The offer of a 12-week chair-based yoga programme in addition to usual care did not improve HRQOL in older adults with multiple long-term conditions. However, the intervention was safe, acceptable, and probably cost-effective.

Keywords: Yoga; aged; multimorbidity; health-related quality of life; randomised controlled trial.

Grants and funding

This study was funded by the NIHR Health Technology Assessment Programme (reference 17/94/36). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The funder had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.