Conducted by leading health care economists, biostatisticians and occupational therapy scholars, the study is the first to measure the impact of preventive occupational therapy on the "well elderly."
Study participants reported marked improvements in their quality of life, including better physical and emotional well-being. Data collected from the study also identified a trend toward decreased medical costs resulting from the need for fewer physician visits and prescription drugs.
"Occupational therapy is highly cost-effective and a much better use of scarce health care resources than many other interventions routinely prescribed for senior citizens, which may have a marginal benefit to the overall health of the patient," said Joel Hay, Ph.D., lead author of the study and associate professor of pharmaceutical economics and policy of the USC School of Pharmacy. "We held the treatment up against the industry standard for measuring cost-effectiveness, comparing it to therapies such as heart bypass surgery and breast cancer chemotherapy. We demonstrated that occupational therapy is an enormous value for the money."
The 15-month "Well-Elderly Study" involved three groups of culturally diverse, independent adults over the age of 60 who lived in federally subsidized housing in Los Angeles. One group participated in an occupational therapy life-style redesign program; an active control group engaged in organized activities, but did not receive occupational therapy; and the third group received no intervention. "What is particularly important is the significant quality-of-life improvements that the occupational therapy group reported were achieved without increasing health care costs compared with the control groups," Hay added.
"Through life style redesign by an occupational therapist, each senior citizen enacted a health-promoting routine that was customized for their life situation," said Florence Clark, Ph.D., OTR, FAOTA, principal investigator of the study and professor and chair of the USC Department of Occupational Science and Occupational Therapy. "The key is to build healthy habits into a daily routine that is sustainable and will allow elders to improve their quality of life over time."
This article is the third to result from research conducted by the group of USC health care economists, biostatisticians, geriatric physicians and occupational therapists. The earlier papers, published in the Journal of the American Medical Association and the Journal of Gerontology, concluded that preventive occupational therapy improves health and life satisfaction for seniors and showed that the effects lasted over a period of time.
"The unique aspect of the Well Elderly Study is that the life-style redesign program, as well as the instruments used to measure quality-of-life analyses, were modified to be culturally sensitive for the ethnically diverse cohort of participants," said biostatistician Stanley Azen, Ph.D., professor of preventive medicine of the Keck School of Medicine of USC. "In addition, we were able to bring together multi-disciplinary academic and clinical resources from USC and design a highly-successful, important collaborative project."
"The research results highlight the enormous promise of low technology interventions to improve quality of life and prevent disability among America's aging population," said Arlene S. Bierman, M.D., senior research physician for the federal Agency for Healthcare Research and Quality, one of the study's funding agencies. "Cost-effective, community-based interventions such as preventive occupational therapy can play an important role in fulfilling that promise."
The Well Elderly Study was funded by the National Institute on Aging, the National Center for Medical Rehabilitation Research and the Agency for Health Care Research and Quality. In addition, this research was supported by grants from the American Occupational Therapy Foundation Center at USC for the Study of Occupation and its Relation to Adaptation, The RGK Foundation, Lumex Inc., and Smith & Nephew Rolyan.
Hay J, LaBree L, Luo R, Clark F, Carlson M, Mandel D, Zemke R, Jackson J, Azen S. "Cost-Effectiveness of Preventive Occupational Therapy for Independent Living Adults." Journal of the American Geriatrics Society. August, Volume 50, Issue 8, page 1381-1388, 2002.