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Table 10 Summary of intervention efficacy data used by decision models

From: Economic models of community-based falls prevention: a systematic review with subsequent commissioning and methodological recommendations

Study label (n = 46)a

Intervention type

Efficacy (main model) fall-related event

Data source type

Efficacy (incidence) metric

Effectiveness periodb (model time horizon)

Agartioglu (2020) [50]

HAM

Any fall (any fall)

External meta-an. and internal RCT

RR (risk)

1 year (1 year)

Albert (2016) [51]

Multifactorial int.

Any fall (any fall)

Internal non-randomised

RR (risk)

1 year (1 year)

Alhambra-Borras (2019) [52]

Group exercise

Compositec (composite)

Internal quasi-experiment

RR (risk)

1 year (lifetime)

Beard (2006) [53]

Multifactorial int.

Hospital fall (hospital fall)

Internal quasi-experiment

RaR (rate)

5-year sustainability (5 years)

Boyd (2020) [54]

Expedited cataract surgery

Any fall (MA fall)

External RCT

RR (risk)

1 yeard (lifetime)

Carande-Kulis (2015) [55]

Multiple types

Any fall (MA fall)

External RCTs

RR or RaR (risk)

1 year (1 year)

CSP (2016) [56]

Physiotherapy

Any fall (MA fall)

External meta-an.

RaR (risk)

1 year (1 year)

Church (2011) [57]

Multiple types

Any fall (any fall)

External meta-an.

RaR (risk)

Efficacy durability differ by int. type (10 years)

Church (2012) [58]

Multiple types

Any fall (any fall)

External meta-an.

RaR (risk)

Efficacy durability differ by int. type (lifetime)

Comans (2009) [59]

Multifactorial int.

Any fall (any fall)

External RCT

RaR (risk & rate)

1 year (1 year)

Day (2009) [60]

Multiple types

Any fall (any fall)

External RCTs

RaR (rate)

Efficacy durability same as model time (1, 2 or 5 years)

Day (2010) [61]

Tai Chi

Any fall (any fall)

External meta-an.

RaR (rate)

1 year (1 year)

Deverall (2018) [62]

Multiple exercise types

Any fall (MA fall)

External meta-an.

RaR (risk)

Varying persistence (25 years)

Eldridge (2005) [63]

FRAT; balance and gait int.

Any fall (any fall)

External meta-an.

RR (risk)

Not specified (lifetime)

Farag (2015) [64]

Unspecified

Any fall (any fall)

Assumption

RR (risk)

Not specified (lifetime)

Franklin (2019) [65]

Multiple types

Any fall (any fall)

External meta-an. and RCTs

RR and RaR (risk & rate)

1 year (2 years)

Frick (2010) [66]

Multiple types

Any fall (hip fracture)

External meta-an.

RR (risk)

1 year (1 yeare)

Hektoen (2009) [67]

Home exercise

Any fall (any fall)

External RCT

RaR (rate)

1 year (1 year)

Hiligsmann (2014) [68]

Vit. D + calcium supplement

Mix fracture; (mix fracture)

External meta-an.

RR (risk)

6 yearsf (lifetime)

Hirst (2016) [69]

Buprenorphine vs. Tramadol

Mix fracture (mix fracture)

External surveys

OR (risk)

1 year (1 year)

Honkanen (2006) [70]

Hip protector

Hip fracture (hip fracture)

External RCT

RR (risk)

Varying persistence (20 years)

Howland (2015) [71]

Matter of Balance lay-led

MA fall (MA fall)

External RCT

RR (risk)

1 year (1 year)

Ippoliti (2018) [72]

Multifactorial int.

Hip fracture (hip fracture)

Policy variable

RaR (rate)

3 years (3 years)

Johansson (2008) [73]

Multifactorial int.

Hip fracture (hip fracture)

Internal quasi-experiment

RaR (risk)

1 year (lifetime)

Lee (2013) [74]

Vit. D screening & supplement

Any fall (any fall)

External meta-an.

RR (risk)

2.5 years (3 years)

Ling (2008) [75]

HAM

Any fall (any fall)

External RCT

RR (risk)

1 year (1 year)

McLean (2015) [76]

Exercise

Any fall (any fall)

Internal RCT

RR (risk)

1.5 years (1.5 years)

Miller (2011) [77]

Matter of Balance lay-led

Any fall (any fall)

Policy variable

RR (risk)

2 years (2 years)

Mori (2017) [78]

Exercise & bisphosphonate

Mix fracture (mix fracture)

External meta-analyses

RR or RaR (risk)

1/2 year maintenance (lifetime)

Moriarty (2019) [79]

Withdrawal of PIP mediations

MA fall/Hip fracture (MA fall/hip fracture)

External RCTs

RR (risk)

Lifetime persistence (35 years)

Nshimyumukiza (2013) [80]

Exercise, Vit. D + calcium & osteoporosis int.

Mix fracture (mix fracture)

External meta-an. & surveys

RR (risk)

Lifetime sustainability (lifetime)

OMAS (2008) [81]

Multiple types

Any fall (MA fall)

Internal meta-an.

RR (risk)

Lifetime persistence for 1st year adherers (lifetime)

Pega (2016) [82]

HAM

Any fall (MA fall)

External meta-an.

RaR (risk)

Lifetime or 10-year efficacy (lifetime)

Poole (2014) [83]

Vit. D supplement

Hip fracture (hip fracture)

External meta-an.

HR (rate)

1 year (1 year)

Poole (2015) [84]

Vit. D supplement

Any fall (MA fall)

External meta-an.

RR (risk)

5 years maintenance (5 years)

PHE (2018) [85]

Multiple types

Any fall (any fall)

External meta-an. and RCTs

RaR (rate)

2 years (2 years)

RCN (2005) [34]

Multiple types

Any fall (MA fall)

External meta-an.

RR (risk)

Not specified (lifetime)

Sach (2007); (2010) [86, 87]

Expedited cataract surgery

Any fall (any fall)

Internal RCT

RaR (rate)

Lifetime efficacy durability (lifetime)

Smith (2016) [88]

Risk prediction; Multifactorial int.

Any fall (MA fall)

External meta-an.

RaR (risk)

1 year (1 year)

Tannenbaum (2015) [89]

Insomnia treatments

Any fall (any fall)

External surveys

OR (risk)

Not specified (1 or 5 years)

Turner (2020) [90]

Sedative withdrawal

Hip/non-hip fracture (MA fall, hip/non-hip fracture)

External RCT

RaR (risk)

1 year (1 year)

Velde (2008) [91]

FRID withdrawal

Any fall (any fall)

Internal non-randomised

RaR (rate)

1 year (1 yeare)

Wilson (2017) [92]

HAM

Any fall (MA fall)

External meta-an.

RaR (risk)

Lifetime or 10-year efficacy (lifetime)

Wu (2010) [93]

Multifactorial int.

Any fall (any fall)

External meta-an.

RR (risk)

1 year (1 year)

Zarca (2014) [94]

Vit. D screening & supplement

Vit. D level (vit. D level)

External meta-an. and RCT

Otherg

Varying persistence (lifetime)

  1. Abbreviations: CSP Chartered Society of Physiotherapy, FRID Fall-risk-increasing drug, HAM Home assessment and modification, MA fall Fall requiring medical attention, Met-An. Meta-analysis, OMAS Ontario Medical Advisory Secretariat, OR Odds ratio, PHE Public Health England, PIP Potentially inappropriately prescribed, RaR Rate ratio, RCN Royal College of Nursing, RCT Randomised controlled trial, RR Relative risk, Vit. D Vitamin D
  2. aSee Table 2 for study references; parenthesised number refers to the number of models included in the table
  3. bThe effectiveness period is a function of efficacy durability and implementation sustainability. Key determinants of sustainability are demand-side persistence and supply-side maintenance; not all studies made this distinction
  4. cThis model used a composite outcome including fall-related consequences – recurrent falls, fear of falling and mobility and balance problems – and multivariate frailty index – physical, psychological and social aspects of vulnerability
  5. dAlso includes benefit of cataract surgery on vision: permanent increase of 0.0565 quality-adjusted life year per person
  6. eThe study contained a single one-year cycle but included lifetime healthcare costs and effects of hip fracture
  7. fAfter three years of vitamin D and calcium supplementation, the efficacy would remain for further three years, though declining linearly over that period
  8. gSupplementation increased the vitamin D level which in turn reduced hip fracture risk