RT Journal Article
SR Electronic
T1 Promoting physical activity in older people in general practice: ProAct65+ cluster randomised controlled trial
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e731
OP e738
DO 10.3399/bjgp15X687361
VO 65
IS 640
A1 Steve Iliffe
A1 Denise Kendrick
A1 Richard Morris
A1 Mark Griffin
A1 Deborah Haworth
A1 Hannah Carpenter
A1 Tahir Masud
A1 Dawn A Skelton
A1 Susie Dinan-Young
A1 Ann Bowling
A1 Heather Gage
YR 2015
UL http://bjgp.org/content/65/640/e731.abstract
AB Background Regular physical activity reduces falls, hip fractures, and all-cause mortality, but physical activity levels are low in older age groups.Aim To evaluate two exercise programmes promoting physical activity among older people.Design and setting Pragmatic three-arm, parallel-design cluster randomised controlled trial involving 1256 people aged ≥65 years (of 20 507 invited) recruited from 43 general practices in London, Nottingham, and Derby.Method Practices were randomised to the class-based Falls Management Exercise programme (FaME), the home-based Otago Exercise Program (OEP), or usual care. The primary outcome was the proportion reaching the recommended physical activity target 12 months post-intervention. Secondary outcomes included falls, quality of life, balance confidence, and costs.Results In total, 49% of FaME participants reached the physical activity target compared with 38% for usual care (adjusted odds ratio 1.78, 95% confidence interval [CI] =1.11 to 2.87, P = 0.02). Differences between FaME and usual care persisted 24 months after intervention. There was no significant difference comparing those in the OEP (43% reaching target at 12 months) and usual-care arms. Participants in the FaME arm added around 15 minutes of moderate-to-vigorous physical activity per day to their baseline level; this group also had a significantly lower rate of falls (incident rate ratio 0.74, 95% CI = 0.55 to 0.99, P = 0.042). Balance confidence was significantly improved in both intervention arms. The mean cost per extra person achieving the physical activity target was £1740. Attrition and rates of adverse reactions were similar.Conclusion The FaME programme increases self-reported physical activity for at least 12 months post-intervention and reduces falls in people aged ≥65 years, but uptake is low. There was no statistically significant difference in reaching the target, or in falls, between the OEP and usual-care arms.