| Title |
Cost-utility of medication withdrawal in older fallers: results from the improving medication prescribing to reduce risk of FALLs (IMPROveFALL) trial
|
|---|---|
| Published in |
BMC Geriatrics, November 2016
|
| DOI | 10.1186/s12877-016-0354-7 |
| Pubmed ID | |
| Authors |
Suzanne Polinder, Nicole D. A. Boyé, Francesco U. S. Mattace-Raso, Nathalie Van der Velde, Klaas A. Hartholt, Oscar J. De Vries, Paul Lips, Tischa J. M. Van der Cammen, Peter Patka, Ed F. Van Beeck, Esther M. M. Van Lieshout, the IMPROveFALL trial collaborators |
| Abstract |
The use of Fall-Risk-Increasing-Drugs (FRIDs) has been associated with increased risk of falls and associated injuries. This study investigates the effect of withdrawal of FRIDs versus 'care as usual' on health-related quality of life (HRQoL), costs, and cost-utility in community-dwelling older fallers. In a prospective multicenter randomized controlled trial FRIDs assessment combined with FRIDs-withdrawal or modification was compared with 'care as usual' in older persons, who visited the emergency department after experiencing a fall. For the calculation of costs the direct medical costs (intramural and extramural) and indirect costs (travel costs) were collected for a 12 month period. HRQoL was measured at baseline and at 12 months follow-up using the EuroQol-5D and Short Form-12 version 2. The change in EuroQol-5D and Short Form-12 scores over 12 months follow-up within the control and intervention groups was compared using the Wilcoxon Signed Rank test for continuous variables and the McNemar test for dichotomous variables. The change in scores between the control and intervention groups were compared using a two-way analysis of variance. We included 612 older persons who visited an emergency department because of a fall. The mean cost of the FRIDs intervention was €120 per patient. The total fall-related healthcare costs (without the intervention costs) did not differ significantly between the intervention group and the control group (€2204 versus €2285). However, the withdrawal of FRIDs reduced medication costs with a mean of €38 per participant. Furthermore, the control group had a greater decline in EuroQol-5D utility score during the 12-months follow-up than the intervention group (p = 0.02). The change in the Short Form-12 Physical Component Summary and Mental Component Summary scores did not differ significantly between the two groups. Withdrawal of FRID's in older persons who visited an emergency department due to a fall, did not lead to reduction of total health-care costs. However, the withdrawal of FRIDs reduced medication costs with a mean of €38 per participant in combination with less decline in HRQoL is an important result. The trial is registered in the Netherlands Trial Register ( NTR1593 - October 1(st) 2008). |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 5 | 56% |
| Canada | 1 | 11% |
| Unknown | 3 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 67% |
| Practitioners (doctors, other healthcare professionals) | 2 | 22% |
| Scientists | 1 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 85 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 1% |
| Canada | 1 | 1% |
| Unknown | 83 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 14% |
| Student > Master | 11 | 13% |
| Student > Bachelor | 10 | 12% |
| Student > Ph. D. Student | 9 | 11% |
| Student > Postgraduate | 5 | 6% |
| Other | 17 | 20% |
| Unknown | 21 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 26% |
| Nursing and Health Professions | 15 | 18% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 5% |
| Sports and Recreations | 3 | 4% |
| Business, Management and Accounting | 2 | 2% |
| Other | 12 | 14% |
| Unknown | 27 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 January 2017.
All research outputs
#6,461,883
of 23,342,232 outputs
Outputs from BMC Geriatrics
#1,596
of 3,235 outputs
Outputs of similar age
#97,138
of 312,827 outputs
Outputs of similar age from BMC Geriatrics
#20
of 42 outputs
Altmetric has tracked 23,342,232 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 3,235 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one has gotten more attention than average, scoring higher than 50% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 312,827 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 42 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 52% of its contemporaries.