Disregarding these method ological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and , hence , an age-based rationing of public health care
Background In the light of demographic developments health promotion interventions for older people are gaining importance .
In addition to method ological challenges arising from the economic evaluation of health promotion interventions in general , there are specific method ological problems for the particular target group of older people .
There are especially four main method ological challenges that are discussed in the literature .
They concern measurement and valuation of informal caregiving , accounting for productivity costs , effects of unrelated cost in added life years and the inclusion of ‘ beyond-health ’ benefits .
This paper focuses on the question whether and to what extent specific method ological requirements are actually met in applied health economic evaluations .
A preventative lifestyle intervention for older adults (lifestyle matters): a randomised controlled trial
Abstract Objectives to test whether an occupation-based lifestyle intervention can sustain and improve the mental well-being of adults aged 65 years or over compared to usual care , using an individually r and omised controlled trial . Participants 288 independently living adults aged 65 years or over , with normal cognition , were recruited from two UK sites between December 2011 and November 2015 . Interventions lifestyle Matters is a National Institute for Health and Care Excellence recommended multi-component preventive intervention design ed to improve the mental well-being of community living older people at risk of decline . It involves weekly group sessions over 4 months and one to one sessions . Main outcome measures the primary outcome was mental well-being at 6 months ( mental health ( MH ) dimension of the SF-36 ) . Secondary outcomes included physical health dimensions of the SF-36 , extent of depression ( PHQ-9 ) , quality of life ( EQ-5D ) and loneliness ( de Jong Gierveld Loneliness Scale ) , assessed at 6 and 24 months . Results data on 262 ( intervention = 136 ; usual care = 126 ) participants were analysed using intention to treat analysis . Mean SF-36 MH scores at 6 months differed by 2.3 points ( 95 CI : −1.3 to 5.9 ; P = 0.209 ) after adjustments . Conclusions analysis shows little evidence of clinical or cost-effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline . The results pose questions regarding how preventive interventions to promote well-being in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline . Trial Registration IS RCT N67209155
Disregarding these method ological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and , hence , an age-based rationing of public health care
Background In the light of demographic developments health promotion interventions for older people are gaining importance .
In addition to method ological challenges arising from the economic evaluation of health promotion interventions in general , there are specific method ological problems for the particular target group of older people .
There are especially four main method ological challenges that are discussed in the literature .
They concern measurement and valuation of informal caregiving , accounting for productivity costs , effects of unrelated cost in added life years and the inclusion of ‘ beyond-health ’ benefits .
This paper focuses on the question whether and to what extent specific method ological requirements are actually met in applied health economic evaluations .