The 12-week KOKU programme is dominant over usual care in cost-effectiveness, with a significant QALY gain and non-significant cost savings¶

Claim · All claims
Evidence · 1 study (2 entries) · causal r2–r3 · q3 · i1 small
Currency · newest study 2026 · 1 of 2 entries checked against their sources (automated) · not reviewed by a person

Subclaims¶

q3 i1 KOKU was associated with an adjusted incremental fall-related cost of −£59.81 (95% CI −£215.37 to £43.39, not significant) and an average incremental QALY gain of 0.020 (95% CI 0.004 to 0.033, significant), making it dominant. → French Chloe 2026 q3 i? Cost-effectiveness results were robust across sensitivity analyses varying missing data, unit costs and tablet provision, with the intervention remaining dominant under all assumptions. → French Chloe 2026 (2)

Evidence¶

French Chloe 2026¶

French Chloe, Parchment Amelia, Odebiyi Bolanle, Shi Chunhu, Bashir Saima, Dowding Dawn, Kislov Roman, Thompson Alexander, Skelton Dawn A, Clarke Margaret, Sylvestre Garcia Yvonne, Ahmed Saima S, Todd Chris J, Bower Peter, Stanmore Emma. (2026). Effectiveness and cost-effectiveness of the Keep-On-Keep-Up digital falls prevention programme in community-dwelling older adults: results of a randomised controlled trial. Age and Ageing. https://doi.org/10.1093/ageing/afag291

q3 · i1 · causal · r3

Cost-utility analysis from the NHS and Personal Social Services perspective over a 12-week horizon, using regression and non-parametric bootstrapping with 10 005 replications. Delivery cost was £46.17 per person; because the intervention was "both less costly and more effective", no ICER was calculated.

"The KOKU programme was associated with an adjusted incremental fall-related cost of −£59.81 (95% CI −£215.37 to £43.39) and an average incremental QALY gain of 0.020 (95% CI 0.004 to 0.033) over the 12-week period. QALY gain was statistically significant, while the cost difference was not statistically significant, although the point estimate favoured cost savings."

French Chloe 2026 (2)¶

French Chloe, Parchment Amelia, Odebiyi Bolanle, Shi Chunhu, Bashir Saima, Dowding Dawn, Kislov Roman, Thompson Alexander, Skelton Dawn A, Clarke Margaret, Sylvestre Garcia Yvonne, Ahmed Saima S, Todd Chris J, Bower Peter, Stanmore Emma. (2026). Effectiveness and cost-effectiveness of the Keep-On-Keep-Up digital falls prevention programme in community-dwelling older adults: results of a randomised controlled trial. Age and Ageing. https://doi.org/10.1093/ageing/afag291

q3 · i1 · causal · r2

Sensitivity analyses covering complete-case analysis, excluding tablet costs, varying unit costs by ±10%, and assuming one in four participants required a tablet; the authors report the cost-effectiveness results were robust to these alternative assumptions.

"Across sensitivity analyses, incremental fall-related costs remained lower (−£49.21 to −£83.52) and QALYs remained higher (0.019–0.021), compared with usual care, with the intervention remaining dominant under all assumptions"

Discussion¶

Related Claims¶

• The KOKU digital programme improves balance function at 12 weeks compared with standard care in community-dwelling older adults, with the effect increasing over time — related
• KOKU improves lower-limb function, concerns about falling and health-related quality of life, but not mood, physical activity, fatigue or fall rate — related
• Older adults rated the KOKU digital programme with excellent usability and high acceptability — related
• Qualitative findings: ease of use supports engagement and confidence, but challenge must be tailored to ability and content must be culturally relatable — related