Cost-effectiveness of interventions for people with dementia without caregiver: A Systematic Review
Tóm tắt
Objective: This study was conducted to answer the three questions: 1- What intervention with no caregiver to increase cost-effectiveness in patients with dementia have been implemented? 2- How has disease progression changed in these interventions? 3- How has cost effectiveness changed in these interventions?
Methods: The databases were searched from PubMed, Cochrane and Science Direct. Studies on cost-effectiveness of interventions for people with dementia without caregiver published from 2010 to 2020 have been filtered. Systematic review was carried out according to the Cochrane Collaboration methodology. Search for documents based on PICOTS standards: Population - Patients with dementia, regardless of disease severity; Intervention - Intervention with no-caregiver for dementia patients; Comparison - The intervention group and the control group; Outcome measure - Disease progression and Cost effectiveness; Time - Studies published from January to January 2020. Study design: A randomized controlled trial. Study subjects are not age restricted.
Results: 2163 documents were found, of which, there are 15 documents satisfy the criteria. (1) Modes of intervention: There are 3 studies on exercise interventions, 2 studies on drug treatment, the rest are different treatment programs. In which, the START program has done the most studies with 3 studies. (2) Disease progression: Out of the 15 studies, 14 found the difference between the intervention group and the control group. The intervention group mostly had higher QALYs and had better disease progression. (3) Cost-effectiveness: There are 11 out of 15 studies showing the cost-effectiveness of the intervention group compared with the usual care group. 4 remaining studies did not show a cost-effectiveness and there is no evidence of cost-effectiveness unless the service user is willing to pay certain amount for that intervention.
Conclusion: This study shows evidence of no-caregiver interventions that improve dementia and increase the cost-effectiveness of treatment.
Cách trích dẫn
- 1. Davis JC, Bryan S, Marra CA, Hsiung G-YR, Liu-Ambrose T. Challenges with cost-utility analyses of behavioral interventions among older adults at risk for dementia. Br J Sports Med. 2015 Oct;49[20]:1343–7.
- 2. Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005 Dec 17;366[9503]:2112–7.
- 3. Rossi MJ, Lubowitz JH, Brand JC, Provencher MT. Making the Right Treatment Decision Requires Consideration of Utility and Reconsideration of Value. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2017 Feb;33[2]:239–41.
- 4. Zhu CW, Sano M, Ferris SH, Whitehouse PJ, Patterson MB, Aisen PS. Health-Related Resource Use and Costs in Elderly Adults with and without Mild Cognitive Impairment. J Am Geriatr Soc. 2013 Mar;61[3]:396–402.
- 5. Wimo A, Jönsson L, Bond J, Prince M, Winblad B, Alzheimer Disease International. The worldwide economic impact of dementia 2010. Alzheimers Dement J Alzheimers Assoc. 2013 Jan;9[1]:1-11.e3.
- 6. Romeo R, Knapp M, Hellier J, Dewey M, Ballard C, Baldwin R, et al. Cost-effectiveness analyses for mirtazapine and sertraline in dementia: randomised controlled trial. Br J Psychiatry J Ment Sci. 2013 Feb;202:121–8.
- 7. Edvardsson D, Winblad B, Sandman PO. Person- centred care of people with severe Alzheimer’s disease: current status and ways forward. Lancet Neurol. 2008 Apr;7[4]:362–7.
- 8. Bostick JE, Rantz MJ, Flesner MK, Riggs CJ. Systematic review of studies of staffing and quality in nursing homes. J Am Med Dir Assoc. 2006 Jul;7[6]:366–76.
- 9. van Weert JCM, van Dulmen AM, Spreeuwenberg PMM, Bensing JM, Ribbe MW. The effects of the implementation of snoezelen on the quality of working life in psychogeriatric care. Int Psychogeriatr. 2005 Sep;17[3]:407–27.
- 10. Knapp M, King D, Romeo R, Schehl B, Barber J, Griffin M, et al. Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial. BMJ [Internet]. 2013 Oct 25 [cited 2020 Oct 4];347. Available from: https://www.bmj.com/ content/347/bmj.f6342
- 11. Livingston G, Kelly L, Lewis-Holmes E, Baio G, Morris S, Patel N, et al. A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technol Assess Winch Engl. 2014 Jun;18[39]:1–226, v–vi.
- 12. Living well with dementia: a National Dementia Strategy[Internet]. Joint Commissioning Panel for Mental Health. [cited 2020 Oct 4]. Available from: https://www.jcpmh.info/resource/living- well-with-dementia-a-national-dementia- strategy/
- 13. Woods RT, Orrell M, Bruce E, Edwards RT, Hoare Z, Hounsome B, et al. REMCARE: Pragmatic Vu Thi Hue et al.