PMID- 32219499
OWN - NLM
STAT- MEDLINE
DCOM- 20210219
LR  - 20210219
IS  - 1433-2965 (Electronic)
IS  - 0937-941X (Linking)
VI  - 31
IP  - 6
DP  - 2020 Jun
TI  - Describing the resource utilisation and costs associated withvertebral fractures: 
      the Build Better Bones with Exercise (B3E) Pilot Trial.
PG  - 1115-1123
LID - 10.1007/s00198-020-05387-z [doi]
AB  - This analysis examined costs/resources of 141 women with vertebral fractures, 
      randomised to a home exercise programme or control group. Total, mean costs and 
      the incremental cost-effectiveness ratio (ICER) were calculated. Quality of life 
      was collected. Cost drivers were caregiver time, medications and adverse events 
      (AEs). Results show adding an exercise programme may reduce the risk of AEs. 
      INTRODUCTION: This exploratory economic analysis examined the health resource 
      utilisation and costs experienced by women with vertebral fractures, and explored 
      the effects of home exercise on those costs. METHODS: Women >/= 65 years with one 
      or more X-ray-confirmed vertebral fractures were randomised 1:1 to a 12-month 
      home exercise programme or equal attention control group. Clinical and health 
      system resources were collected during monthly phone calls and daily diaries 
      completed by participants. Intervention costs were included. Unit costs were 
      applied to health system resources. Quality of life (QoL) information was 
      collected via EQ-5D-5L at baseline, 6 and 12 months. RESULTS: One hundred and 
      forty-one women were randomised. Overall total costs (CAD 2018) were $664,923 
      (intervention) and $614,033 (control), respectively. The top three cost drivers 
      were caregiver time ($250,269 and $240,811), medications ($151,000 and $122,145) 
      and AEs ($58,807 and $71,981). The mean cost per intervention participant of 
      $9365 +/- $9988 was higher compared with the mean cost per control participant of 
      $8772 +/- $9718. The mean EQ-5D index score was higher for the intervention 
      participants (0.81 +/- 0.11) compared with that of controls (0.79 +/- 0.13). The 
      differences in quality-adjusted life year (QALY) (0.02) and mean cost ($593) were 
      used to calculate the ICER of $29,650. CONCLUSIONS: Women with osteoporosis with 
      a previous fracture experience a number of resources and associated costs that 
      impact their care and quality of life. Caregiver time, medications and AEs are 
      the biggest cost drivers for this population. The next steps would be to expand 
      this feasibility study with more participants, longer-term follow-up and more 
      regional variability.
FAU - Hassan, S
AU  - Hassan S
AUID- ORCID: 0000-0002-3040-9988
AD  - HOPE Research Centre, Sunnybrook Research Institute, Toronto, Ontario, M4N 3M5, 
      Canada. shazia.hassan@sunnybrook.ca.
FAU - Seung, S J
AU  - Seung SJ
AD  - HOPE Research Centre, Sunnybrook Research Institute, Toronto, Ontario, M4N 3M5, 
      Canada.
FAU - Clark, R E
AU  - Clark RE
AD  - University of Waterloo, Waterloo, Canada.
FAU - Gibbs, J C
AU  - Gibbs JC
AD  - McGill University, Montreal, Quebec, Canada.
FAU - McArthur, C
AU  - McArthur C
AD  - McMaster University, Hamilton, Canada.
FAU - Mittmann, N
AU  - Mittmann N
AD  - Cancer Care Ontario, Toronto, Canada.
FAU - Thabane, L
AU  - Thabane L
AD  - McMaster University, Hamilton, Canada.
FAU - Kendler, D
AU  - Kendler D
AD  - University of British Columbia, Vancouver, Canada.
FAU - Papaioannou, A
AU  - Papaioannou A
AD  - McMaster University, Hamilton, Canada.
FAU - Wark, J D
AU  - Wark JD
AD  - University of Melbourne, Melbourne, Australia.
FAU - Ashe, M C
AU  - Ashe MC
AD  - University of British Columbia, Vancouver, Canada.
FAU - Adachi, J D
AU  - Adachi JD
AD  - McMaster University, Hamilton, Canada.
FAU - Templeton, J A
AU  - Templeton JA
AD  - University of Waterloo, Waterloo, Canada.
FAU - Giangregorio, L M
AU  - Giangregorio LM
AD  - University of Waterloo, Waterloo, Canada.
LA  - eng
GR  - 123445/Canadian Institutes of Health Research (CA)/
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20200326
PL  - England
TA  - Osteoporos Int
JT  - Osteoporosis international : a journal established as result of cooperation 
      between the European Foundation for Osteoporosis and the National Osteoporosis 
      Foundation of the USA
JID - 9100105
SB  - IM
MH  - Aged
MH  - *Cost-Benefit Analysis
MH  - *Exercise Therapy
MH  - Female
MH  - *Health Care Costs
MH  - Humans
MH  - Pilot Projects
MH  - Quality of Life
MH  - Quality-Adjusted Life Years
MH  - Spinal Fractures/*economics
OTO - NOTNLM
OT  - Exercise
OT  - Health system costs
OT  - Osteoporosis
OT  - Resource utilisation
OT  - Vertebral fractures
EDAT- 2020/03/29 06:00
MHDA- 2021/02/20 06:00
CRDT- 2020/03/29 06:00
PHST- 2019/11/22 00:00 [received]
PHST- 2020/03/10 00:00 [accepted]
PHST- 2020/03/29 06:00 [pubmed]
PHST- 2021/02/20 06:00 [medline]
PHST- 2020/03/29 06:00 [entrez]
AID - 10.1007/s00198-020-05387-z [pii]
AID - 10.1007/s00198-020-05387-z [doi]
PST - ppublish
SO  - Osteoporos Int. 2020 Jun;31(6):1115-1123. doi: 10.1007/s00198-020-05387-z. Epub 
      2020 Mar 26.