The Exercise Right for Active Ageing study: A pre-post evaluation of health-related quality of life and cost-utility in older Australians following a 12-week exercise programme

Objectives: To determine the effect of a 12-week subsidised exercise programme on health-related quality of life (HRQoL) in community-dwelling older Australians, and the cost-utility of the programme. Design: Quasi-experimental, pre-post study. Methods: Participants included community-dwelling older adults, aged ≥ 65 years, from every state and territory of Australia. The intervention consisted of 12 one-hour, weekly, low-to-moderate-intensity exercise classes, delivered by accredited exercise scientists or physiologists (AESs/AEPs). Health-related quality of life was measured before and after programme participation using the EQ-5D-3L and converted to a utility index using Australian value tariffs. Participant, organisational and service provider costs were reported. Multivariable linear mixed models were used to evaluate the change in HRQoL following programme completion. Cost-utility outcomes were reported as incremental cost-effectiveness ratios (ICERs), based on programme costs and the change in utility scores. Results: 3511 older adults (77 % female) with a median (IQR) age of 72 (69–77) years completed follow-up testing. There was a small improvement in EQ-5D-3L utility scores after programme completion (0.04, 95 % CI: 0.04, 0.05, p < 0.001). The cost per quality-adjusted life year (QALY) gained was $12,893. Conclusions: Older Australians who participated in the Exercise Right for Active Ageing programme reported small improvements in HRQoL following programme completion, and this included older adults living in regional/rural areas. Funding subsidised exercise classes, may be a low-cost strategy for improving health outcomes in older adults and reducing geographic health disparities. Clinical trial registration: The study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12623000483651).