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RESPOND: a programme to prevent secondary falls in older people presenting to the emergency department with a fall: protocol for an economic evaluation
  1. R T Morello1,
  2. R L Morris1,
  3. K D Hill2,
  4. T P Haines3,
  5. G Arendts4,
  6. J Redfern5,
  7. C D Etherton-Beer6,7,
  8. J A Lowthian8,
  9. C A Brand1,
  10. D Liew1,
  11. J J Watts9,
  12. A L Barker1
  1. 1Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
  3. 3Department of Physiotherapy, Monash University, Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia
  4. 4School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Nedlands, Western Australia, Australia
  5. 5The George Institute for Global Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
  6. 6University of Western Australia, Perth, Western Australia, Australia
  7. 7Western Australian Institute for Medical Research, Perth, Western Australia, Australia
  8. 8Pre-Hospital, Emergency and Trauma Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  9. 9Centre for Population Health Research, Deakin University, Melbourne, Victoria, Australia
  1. Correspondence to Renata Morello, Health Services Research Unit, Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia; Renata.Morello{at}monash.edu

Abstract

Background Falls remain common for community-dwelling older people and impose a substantial economic burden to the healthcare system. RESPOND is a novel falls prevention programme that aims to reduce secondary falls and fall injuries among older people who present to a hospital emergency department (ED) with a fall. The present protocol describes a prospective economic evaluation examining the incremental cost-effectiveness of the RESPOND programme, compared with usual care practice, from the Australian health system perspective.

Methods and design This economic evaluation will recruit 528 participants from two major tertiary hospital EDs in Australia and will be undertaken alongside a multisite randomised controlled trial. Outcome and costing data will be collected for all participants over the 12-month trial. It will compare the RESPOND falls prevention programme with usual care practice (current community-based falls prevention practices) to determine its incremental cost-effectiveness according to three intermediate clinical outcomes: (1) falls prevented, (2) fall injuries prevented and (3) injurious falls prevented. In addition, utilities will be derived from a generic quality-of-life measure (EQ-5D-5L) and used to calculate the ‘incremental cost per quality-adjusted life years gained’.

Discussion The results of this study will provide healthcare decision makers with evidence to assist with setting spending thresholds for preventive health programmes and inform selection of emergency and community service models of care.

Trial registration number The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684); Pre-results.

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Footnotes

  • 1. Health Strategy and Networks Branch, Strategic System Policy and Planning, Department of Health, WA

  • 2. Aged and Continuing Care Directorate, Department of Health, WA

  • 3. Royal Perth Hospital

  • 4. Curtin University

  • 5. The University of Western Australia

  • 6. The Royal Perth Hospital Medical Research Foundation

  • 7. Sir Charles Gairdner Hospital Area Rehabilitation and Aged Care Falls Specialist Program

  • 8. Injury Control Council of Western Australia

  • 9. The George Institute for Global Health

  • 10. The Alfred Hospital

  • 11. Monash University

  • 12. Integrated Care, Victorian Department of Health

  • Contributors All authors contributed to the conception and design of this study, the drafting and revision of this article and provided final approval of the version to be published.

  • Funding This project is funded under the Australian National Health and Medical Research Council's Partnership Projects funding scheme (project number APP1056802) with financial and in-kind contributions from the partner organisations listed above. ALB was supported by a Career Development Fellowship funded by the NHMRC (1067236). JR was supported by a Postdoctoral Fellowship co-funded by the NHMRC and National Heart Foundation (632933). JAL was supported by an Early Career Fellowship funded by the NHMRC (1052442). TPH was supported by an NHMRC Career Development Fellowship (APP1069758)

  • Competing interests None declared.

  • Ethics approval Ethics approval was obtained from each participating hospital site, Alfred Health (HREC 439/13) and Royal Perth Hospital (REG 13-128) and Monash University Human Research Ethics Committee (MUHREC CF13/3869-201300).

  • Provenance and peer review Not commissioned; internally peer reviewed.

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