Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons: Randomized Controlled Trial

Objectives Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study effects home-based physical exercise on number days spent at home among pre-frail frail persons, versus usual care. In addition, utilization costs health care social services, cost-effectiveness, health-related quality-of-life (HRQoL) were explored. Design Randomized controlled trial, with year-long supervised for 60 minutes twice a week Follow-up 24 months after randomization. Setting Participants A sample 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: ?65 years, meeting least 1 frailty phenotype criteria, Mini-Mental State Examination score ?17. Methods Primary outcome, over months, calculated deducting inpatient care, nursing homes, HRQoL assessed (15D questionnaire) baseline 3, 6, 12 months. Utilization data retrieved from medical records. Results The participants' mean age 82.5 (SD 6.3), 75% women, 61% 39% frail. After there no difference between groups [incidence rate ratio 1.03; 95% confidence interval (CI) 0.98–1.09]. per person-year 1.60-fold group (95% CI 1.23–1.98), 1.23-fold 0.95–1.50) Over gained 0.04 quality-adjusted life-years maintained 15D level, while deteriorated (P <.001, time 0.002, interaction 0.004). Conclusions Implications Physical did not increase home. Exercise prevented deterioration HRQoL, subgroup, all intervention compensated decreased other services