An exercise and incontinence intervention did not reduce the incidence or cost of acute conditions in nursing home residents
QUESTION: In nursing home (NH) residents, does an intervention combining low intensity exercise and incontinence care offset its costs by reducing selected health conditions?
Design
Cost effectiveness analysis of a randomised {allocation concealed}*, blinded ({data collectors}* and outcome assessors), controlled trial with follow up at 8 and 32 weeks.
Setting
4 NHs in the US.
Patients
190 NH residents (mean age 88 y, 85% women) with urinary incontinence who did not have catheters, could follow a simple 1 step instruction, and were not on Medicare Part A reimbursement for post-acute skilled care or terminal illness. Follow up was 91% at 8 weeks and 78% at 32 weeks.
Intervention
Patients were allocated to an 8 month exercise programme (Functional Incidental Training [FIT]) (n=92) or to usual care (n=98). The FIT intervention was implemented every 2 hours during the day for 5 days per week and involved prompts to toilet and changing if wet, encouragement to walk (or wheel their wheelchairs), repeat sit to stands up to 8 times, and practise upper body resistance training (arm curls or arm raises) once per day when in bed. Patients were offered fluids after each exercise trial.
Main cost and outcome measures
Acute conditions relating …
