Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial

被引:53
作者
D'Amico, Francesco [1 ]
Rehill, Amritpal [1 ]
Knapp, Martin [1 ]
Aguirre, Elisa [2 ]
Donovan, Helen [3 ]
Hoare, Zoe [4 ]
Hoe, Juanita [5 ]
Russell, Ian [6 ]
Spector, Aimee [7 ]
Streater, Amy [2 ]
Whitaker, Christopher [4 ]
Woods, Robert T. [8 ]
Orrell, Martin [5 ]
机构
[1] Univ London London Sch Econ & Polit Sci, Personal Social Serv Res Unit, London WC2A 2AE, England
[2] North East London NHS Fdn Trust, Goodmayes Hosp, Dementia Care Res Ctr, Dept Res & Dev, Ilford, Essex, England
[3] South Essex Partnership NHS Fdn Trust, Healthlink, Clin Psychol Serv, Bedford, England
[4] Inst Med & Social Care Res, North Wales Org Randomised Trials Hlth NWORTH, Bangor, Gwynedd, Wales
[5] UCL, Div Psychiat, London, England
[6] Swansea Univ, Coll Med, Swansea, W Glam, Wales
[7] UCL, Res Dept Clin Educ & Hlth Psychol, London, England
[8] Bangor Univ, DSDC Wales, Bangor, Gwynedd, Wales
关键词
Cognitive stimulation therapy; dementia; cost; cost-effectiveness; randomized controlled trial; acetylcholinesterase inhibitors; QUALITY-OF-LIFE; COST-EFFECTIVENESS; SINGLE-BLIND; DEMENTIA; PEOPLE; MULTICENTER; INVENTORY; SCALE;
D O I
10.1016/j.jamda.2014.10.020
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background: Cognitive Stimulation Therapy (CST) is effective and cost-effective for people with mild-to-moderate dementia when delivered biweekly over 7 weeks. Aims: To examine whether longer-term (maintenance) CST is cost-effective when added to usual care. Methods: Cost-effectiveness analysis within multicenter, single-blind, pragmatic randomized controlled trial; subgroup analysis for people taking acetylcholinesterase inhibitors (ACHEIs). A total of 236 participants with mild-to-moderate dementia received CST for 7 weeks. They were randomized to either weekly maintenance CST added to usual care or usual care alone for 24 weeks. Results: Although outcome gains were modest over 6 months, maintenance CST appeared cost-effective when looking at self-rated quality of life as primary outcome, and cognition (MMSE) and proxy-rated quality-adjusted life years as secondary outcomes. CST in combination with ACHEIs offered cost-effectiveness gains when outcome was measured as cognition. Conclusions: Continuation of CST is likely to be cost-effective for people with mild-to-moderate dementia. (C) 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
引用
收藏
页码:63 / 70
页数:8
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