Cost-effectiveness of individualized nutrition and exercise therapy for rehabilitation following hip fracture

Abstract

A comprehensive 6-month programme of therapy from dietitians and physical therapists could be provided at a relatively low additional cost in this group of frail older adults, and the incremental cost-effectiveness ratio indicates likely cost-effectiveness, although there was a very high level of uncertainty in the findings.

Effectiveness of combined exercise and nutrition interventions in prefrail or frail older hospitalised patients: a systematic review and meta-analysis

“…Fairhall et al 32 reported no additional resource cost in terms of medical (p=0.87) or nursing and health professional appointments (p=0.32). Similarly, Milte et al 41 reported no cost differences between groups (p=0.868).…”

“…28 In one study that reported C reactive protein levels, this inflammatory marker remained stable in the exercise-nutrition intervention group participants, compared with an increase in the social support control group at the end of 12 weeks (p=0.04). 38 Quality of life and falls Three studies 32 37 41 that evaluated QoL did not find a statistically significant improvement in the intervention as compared with the control group, although Milte et al 41 found a trend favouring intervention. Fairhall et al 31 found that risk factors related to falls (physical tests as mentioned above) but not rate of falls were reduced while Kapan et al 36 found that a 10% reduction in fear of falling as ascertained by the falls efficacy scale.…”

Time for food - training physiatrists in nutritional prescription

“…Thus, nutritional education, as provided by a registered dietitian, has been shown to improve disease outcomes and reduced costs (52). Indeed, patients following a hip fracture who were allocated to receive weekly visits from a physical therapist and dietitian improved quality-adjusted life years in a cost-effective 6-month rehabilitation programme (53).…”

Quality of Life as a Biomarker in Hip Fractures

“…Recently, several aspects were examined, such as surgical approach for hemiarthroplasty (Leonardsson et al 2016), red blood cell transfusion (Gregersen 2016), protein-rich nutritional supplementation and bisphosphonates (Flodin et al 2015), individualized nutrition and exercise therapy (Milte et al 2016), or motivational interviewing (O'Halloran et al 2015). Leonardsson et al (2016) has analyzed 2118 patients (mean age of 85 years) from the Swedish Hip Arthroplasty Register aged 70 years and above who underwent a hemiarthroplasty for a fracture.…”