■患有多种疾病的老年人经历与健康相关的生活质量和治疗负担受损。瑜伽有可能改善健康和福祉的几个方面。英国瑜伽之轮的温和岁月瑜伽©计划是专门为老年人开发的,包括那些有慢性病的人。一项试点试验证明了在该人群中使用温和瑜伽的可行性,但其有效性和成本效益的证据有限.
■为了确定温和岁月瑜伽计划的有效性和成本效益,除了常规护理与常规护理之外,在患有多发病率的老年人中。
■务实,多站点,具有嵌入式经济和过程评估的单独随机对照试验。
■参与者从2019年7月起从英格兰和威尔士的15个一般实践中招募,并在2022年10月进行最后随访。
■居住在社区的65岁及以上的成年人,患有多种疾病,定义为预定义列表中的两个或多个慢性健康状况。
■所有参与者继续接受小学提供的任何常规护理,次要,社区和社会服务。为干预组提供了为期12周的温和瑜伽课程。
■主要结果和终点是使用EuroQol-5维度测量的健康相关生活质量,超过12个月的五级版本效用指数得分。次要结果是健康相关的生活质量,抑郁症,焦虑,孤独,跌倒的发生率,不良事件和医疗资源使用。
■454名随机参与者的平均年龄为73.5岁;60.6%为女性,参与者有三个慢性疾病的中位数。主要分析包括422名参与者(干预,n=240中的227,94.6%;常规护理,n=214中的195,91.1%)。EuroQol-5维度没有统计学或临床上的显著差异,12个月的五级版本效用指数得分:干预组的预测平均得分为0.729(95%置信区间为0.712至0.747),常规护理为0.710[95%置信区间(CI)0.691至0.729],调整后的平均差为0.020,有利于干预(95%CI-0.006至0.045,p=0.14)。次要结局无统计学差异,患者报告结果测量信息系统-29的疼痛项目除外。不认真,报告了相关的不良事件.每位参与者的干预费用比常规护理多80.85英镑(95%CI76.73英镑至84.97英镑),每位参与者产生额外的0.0178质量调整生命年(95%CI0.0175至0.0180),并且在美国国家健康与护理卓越研究所获得的每质量调整生命年20,000英镑的阈值中具有成本效益的概率为79%。参与者可以接受干预,有七个课程面对面和12个在线。
■自我报告的结果数据增加了非盲试验中偏倚的可能性。COVID-19大流行影响了招聘,随访和干预交付模式。
■尽管在健康相关的生活质量方面,温和的瑜伽计划与任何统计上显著的益处无关,心理健康,孤独或跌倒,干预是安全的,大多数参与者都可以接受,一些人也很重视。经济评估表明,干预措施可能具有成本效益。
■长期成本效益建模和确定最有可能从这种干预中受益的人群亚组。
■本试验注册为ISRCTN13567538。
■该奖项由美国国家卫生与护理研究所(NIHR)卫生技术评估计划(NIHR奖参考:17/94/36)资助,并在《卫生技术评估》中全文发布。28号53.有关更多奖项信息,请参阅NIHR资助和奖励网站。
老年人通常有两种或两种以上的长期健康状况。这些情况对生活质量的影响不同,有些人感觉很好,另一些人需要医疗保健支持。温和岁月瑜伽计划旨在改善老年人的生活质量,包括那些有长期健康状况的人。我们想看看该计划的效果如何,以及它是否为NHS提供了物有所值的服务。我们测试了提供12周的温和瑜伽课程是否可以改善生活质量并减少焦虑,抑郁症,65岁及以上有两种或两种以上长期健康状况的人的孤独感和跌倒。我们通过英格兰和威尔士的一般实践招募了454人,随机选择240人参加温和的瑜伽计划,其他214人继续他们的日常护理,不提供温和的瑜伽。参与者的平均年龄是74岁,近三分之二为女性,长期健康状况参与者的数量为2~9人(平均为3人).他们在12个月的时间内完成了四份问卷。我们还采访了一些参与者和瑜伽老师,以了解该方法在实践中的效果。瑜伽是面对面或在线进行的。我们在生活质量方面没有发现任何显著的好处,焦虑,抑郁症,孤独或跌倒。面试时,一些瑜伽参与者注意到对他们的健康或生活方式没有影响或影响不大,而其他人则将温柔的岁月瑜伽描述为变革,对他们的身体健康和情绪健康有重大影响和改善。因为开办瑜伽课相对便宜,而且还看到了一些微不足道的好处,温柔岁月瑜伽计划可能物有所值。
UNASSIGNED: Older adults with multimorbidity experience impaired health-related quality of life and treatment burden. Yoga has the potential to improve several aspects of health and well-being. The British Wheel of Yoga\'s Gentle Years Yoga© programme was developed specifically for older adults, including those with chronic conditions. A pilot trial demonstrated feasibility of using Gentle Years Yoga in this population, but there was limited evidence of its effectiveness and cost-effectiveness.
UNASSIGNED: To determine the effectiveness and cost-effectiveness of the Gentle Years Yoga programme in addition to usual care versus usual care alone in older adults with multimorbidity.
UNASSIGNED: Pragmatic, multisite, individually randomised controlled trial with embedded economic and process evaluations.
UNASSIGNED: Participants were recruited from 15 general practices in England and Wales from July 2019 with final follow-up in October 2022.
UNASSIGNED: Community-dwelling adults aged 65 years and over with multimorbidity, defined as two or more chronic health conditions from a predefined list.
UNASSIGNED: All participants continued with any usual care provided by primary, secondary, community and social services. The intervention group was offered a 12-week programme of Gentle Years Yoga.
UNASSIGNED: The primary outcome and end point were health-related quality of life measured using the EuroQol-5 Dimensions, five-level version utility index score over 12 months. Secondary outcomes were health-related quality of life, depression, anxiety, loneliness, incidence of falls, adverse events and healthcare resource use.
UNASSIGNED: The mean age of the 454 randomised participants was 73.5 years; 60.6% were female, and participants had a median of three chronic conditions. The primary analysis included 422 participants (intervention, n = 227 of 240, 94.6%; usual care, n = 195 of 214, 91.1%). There was no statistically or clinically significant difference in the EuroQol-5 Dimensions, five-level version utility index score over 12 months: the predicted mean score for the intervention group was 0.729 (95% confidence interval 0.712 to 0.747) and for usual care it was 0.710 [95% confidence interval (CI) 0.691 to 0.729], with an adjusted mean difference of 0.020 favouring intervention (95% CI -0.006 to 0.045, p = 0.14). No statistically significant differences were observed in secondary outcomes, except for the pain items of the Patient-Reported Outcomes Measurement Information System-29. No serious, related adverse events were reported. The intervention cost £80.85 more per participant (95% CI £76.73 to £84.97) than usual care, generated an additional 0.0178 quality-adjusted life-years per participant (95% CI 0.0175 to 0.0180) and had a 79% probability of being cost-effective at the National Institute for Health and Care Excellence threshold of £20,000 per quality-adjusted life-year gained. The intervention was acceptable to participants, with seven courses delivered face to face and 12 online.
UNASSIGNED: Self-reported outcome data raise the potential for bias in an unblinded trial. The COVID-19 pandemic affected recruitment, follow-up and the mode of intervention delivery.
UNASSIGNED: Although the Gentle Years Yoga programme was not associated with any statistically significant benefits in terms of health-related quality of life, mental health, loneliness or falls, the intervention was safe, acceptable to most participants and highly valued by some. The economic evaluation suggests that the intervention could be cost-effective.
UNASSIGNED: Longer-term cost-effectiveness modelling and identifying subgroups of people who are most likely to benefit from this type of intervention.
UNASSIGNED: This trial is registered as ISRCTN13567538.
UNASSIGNED: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/94/36) and is published in full in Health Technology Assessment; Vol. 28, No. 53. See the NIHR Funding and Awards website for further award information.
It is common for older adults to have two or more long-term health conditions. These conditions affect quality of life differently, with some people feeling well and others needing healthcare support. The Gentle Years Yoga programme was developed to improve quality of life for older adults, including those with long-term health conditions. We wanted to see how well the programme worked and if it offered good value for money for the NHS. We tested whether offering a 12-week course of Gentle Years Yoga improved the quality of life and reduced anxiety, depression, loneliness and falls for people aged 65 years and over who had two or more long-term health conditions. We recruited 454 people through general practices across England and Wales, with 240 people selected at random to be invited to take part in the Gentle Years Yoga programme and the other 214 to continue with their usual care and not be offered Gentle Years Yoga. The average age of participants was 74 years, nearly two-thirds were female and the number of long-term health conditions participants had ranged from two to nine (average was three). They completed four questionnaires over a 12-month period. We also interviewed some of the participants and the yoga teachers to find out how the approach worked in practice. The yoga was delivered either face to face or online. We did not find any significant benefits in terms of quality of life, anxiety, depression, loneliness or falls. At interview, some yoga participants noted no or a modest impact on their health or lifestyle, while others described Gentle Years Yoga as transformative, having substantial impacts and improvements on their physical health and emotional well-being. Because running the yoga classes was relatively inexpensive and some insignificant benefits were seen, the Gentle Years Yoga programme may be good value for money.