Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial
Abstract 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 analysi...
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| Veröffentlicht in: | Journal of the American Medical Directors Association 2015, Vol.16 (1), p.63-70 |
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| creator | D'Amico, Francesco, PhD Rehill, Amritpal, BSc Knapp, Martin, PhD Aguirre, Elisa, PhD Donovan, Helen, DClinPsych Hoare, Zoe, PhD Hoe, Juanita, PhD Russell, Ian, DSc Spector, Aimee, PhD, DClinPsy Streater, Amy, MSc Whitaker, Christopher, MSc Woods, Robert T., MA, MSc Orrell, Martin, PhD, FRCPsych |
| description | Abstract 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. |
| doi_str_mv | 10.1016/j.jamda.2014.10.020 |
| format | Article |
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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.</description><identifier>ISSN: 1525-8610</identifier><identifier>EISSN: 1538-9375</identifier><identifier>DOI: 10.1016/j.jamda.2014.10.020</identifier><identifier>PMID: 25528281</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>acetylcholinesterase inhibitors ; Activities of Daily Living ; Aged ; Aged, 80 and over ; Cholinesterase Inhibitors - therapeutic use ; Cognitive stimulation therapy ; Cognitive Therapy - economics ; Cognitive Therapy - methods ; cost ; Cost-Benefit Analysis ; cost-effectiveness ; dementia ; Dementia - drug therapy ; Dementia - rehabilitation ; Female ; Humans ; Internal Medicine ; Male ; Medical Education ; Neuropsychological Tests ; Quality of Life ; randomized controlled trial ; Single-Blind Method ; Treatment Outcome</subject><ispartof>Journal of the American Medical Directors Association, 2015, Vol.16 (1), p.63-70</ispartof><rights>AMDA – The Society for Post-Acute and Long-Term Care Medicine</rights><rights>2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine</rights><rights>Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-aeb7450d06e1fa0192ebf7174545a07bb8fae5e2e7c816877076cbfd64704703</citedby><cites>FETCH-LOGICAL-c459t-aeb7450d06e1fa0192ebf7174545a07bb8fae5e2e7c816877076cbfd64704703</cites><orcidid>0000-0002-0069-479X ; 0000-0003-3826-2711</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jamda.2014.10.020$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3548,4021,27921,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25528281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>D'Amico, Francesco, PhD</creatorcontrib><creatorcontrib>Rehill, Amritpal, BSc</creatorcontrib><creatorcontrib>Knapp, Martin, PhD</creatorcontrib><creatorcontrib>Aguirre, Elisa, PhD</creatorcontrib><creatorcontrib>Donovan, Helen, DClinPsych</creatorcontrib><creatorcontrib>Hoare, Zoe, PhD</creatorcontrib><creatorcontrib>Hoe, Juanita, PhD</creatorcontrib><creatorcontrib>Russell, Ian, DSc</creatorcontrib><creatorcontrib>Spector, Aimee, PhD, DClinPsy</creatorcontrib><creatorcontrib>Streater, Amy, MSc</creatorcontrib><creatorcontrib>Whitaker, Christopher, MSc</creatorcontrib><creatorcontrib>Woods, Robert T., MA, MSc</creatorcontrib><creatorcontrib>Orrell, Martin, PhD, FRCPsych</creatorcontrib><title>Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial</title><title>Journal of the American Medical Directors Association</title><addtitle>J Am Med Dir Assoc</addtitle><description>Abstract 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.</description><subject>acetylcholinesterase inhibitors</subject><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cholinesterase Inhibitors - therapeutic use</subject><subject>Cognitive stimulation therapy</subject><subject>Cognitive Therapy - economics</subject><subject>Cognitive Therapy - methods</subject><subject>cost</subject><subject>Cost-Benefit Analysis</subject><subject>cost-effectiveness</subject><subject>dementia</subject><subject>Dementia - drug therapy</subject><subject>Dementia - rehabilitation</subject><subject>Female</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical Education</subject><subject>Neuropsychological Tests</subject><subject>Quality of Life</subject><subject>randomized controlled trial</subject><subject>Single-Blind Method</subject><subject>Treatment Outcome</subject><issn>1525-8610</issn><issn>1538-9375</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2LFDEQhoMo7rr6CwTpo5cek3TnowWFZRg_YEVwBzyGdLraTZtOxiQ9MP56087qwYsQSPHWW1XJUwg9J3hDMOGvps2k50FvKCZtUTaY4gfokrBG1l0j2MM1pqyWnOAL9CSlCRcH6fhjdEEZo5JKconGT9r6DF57A9U2fPM22yNUt9nOi9PZBl_t7yDqw-l1de2rnQk-zNZUu6N2yzn_1eY76ytdfdF-KMmfMJROPsfgXAn30Wr3FD0atUvw7P6-Qvt3u_32Q33z-f3H7fVNbVrW5VpDL1qGB8yBjLo8lkI_ClK0lmks-l6OGhhQEEYSLoXAgpt-HHgrcDnNFXp5bnuI4ccCKavZJgPOaQ9hSYrwpuuE5N1qbc5WE0NKEUZ1iHbW8aQIVitfNanffNXKdxULvVL14n7A0s8w_K35A7QY3pwNUH55tBBVMhYK3MFGMFkNwf5nwNt_6o2z3hrtvsMJ0hSW6AtARVSiCqvbdcXrhkmLMe-kaH4BCquiEg</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>D'Amico, Francesco, PhD</creator><creator>Rehill, Amritpal, BSc</creator><creator>Knapp, Martin, PhD</creator><creator>Aguirre, Elisa, PhD</creator><creator>Donovan, Helen, DClinPsych</creator><creator>Hoare, Zoe, PhD</creator><creator>Hoe, Juanita, PhD</creator><creator>Russell, Ian, DSc</creator><creator>Spector, Aimee, PhD, DClinPsy</creator><creator>Streater, Amy, MSc</creator><creator>Whitaker, Christopher, MSc</creator><creator>Woods, Robert T., MA, MSc</creator><creator>Orrell, Martin, PhD, FRCPsych</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0069-479X</orcidid><orcidid>https://orcid.org/0000-0003-3826-2711</orcidid></search><sort><creationdate>2015</creationdate><title>Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial</title><author>D'Amico, Francesco, PhD ; Rehill, Amritpal, BSc ; Knapp, Martin, PhD ; Aguirre, Elisa, PhD ; Donovan, Helen, DClinPsych ; Hoare, Zoe, PhD ; Hoe, Juanita, PhD ; Russell, Ian, DSc ; Spector, Aimee, PhD, DClinPsy ; Streater, Amy, MSc ; Whitaker, Christopher, MSc ; Woods, Robert T., MA, MSc ; Orrell, Martin, PhD, FRCPsych</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-aeb7450d06e1fa0192ebf7174545a07bb8fae5e2e7c816877076cbfd64704703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>acetylcholinesterase inhibitors</topic><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cholinesterase Inhibitors - therapeutic use</topic><topic>Cognitive stimulation therapy</topic><topic>Cognitive Therapy - economics</topic><topic>Cognitive Therapy - methods</topic><topic>cost</topic><topic>Cost-Benefit Analysis</topic><topic>cost-effectiveness</topic><topic>dementia</topic><topic>Dementia - drug therapy</topic><topic>Dementia - rehabilitation</topic><topic>Female</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical Education</topic><topic>Neuropsychological Tests</topic><topic>Quality of Life</topic><topic>randomized controlled trial</topic><topic>Single-Blind Method</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>D'Amico, Francesco, PhD</creatorcontrib><creatorcontrib>Rehill, Amritpal, BSc</creatorcontrib><creatorcontrib>Knapp, Martin, PhD</creatorcontrib><creatorcontrib>Aguirre, Elisa, PhD</creatorcontrib><creatorcontrib>Donovan, Helen, DClinPsych</creatorcontrib><creatorcontrib>Hoare, Zoe, PhD</creatorcontrib><creatorcontrib>Hoe, Juanita, PhD</creatorcontrib><creatorcontrib>Russell, Ian, DSc</creatorcontrib><creatorcontrib>Spector, Aimee, PhD, DClinPsy</creatorcontrib><creatorcontrib>Streater, Amy, MSc</creatorcontrib><creatorcontrib>Whitaker, Christopher, MSc</creatorcontrib><creatorcontrib>Woods, Robert T., MA, MSc</creatorcontrib><creatorcontrib>Orrell, Martin, PhD, FRCPsych</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Medical Directors Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>D'Amico, Francesco, PhD</au><au>Rehill, Amritpal, BSc</au><au>Knapp, Martin, PhD</au><au>Aguirre, Elisa, PhD</au><au>Donovan, Helen, DClinPsych</au><au>Hoare, Zoe, PhD</au><au>Hoe, Juanita, PhD</au><au>Russell, Ian, DSc</au><au>Spector, Aimee, PhD, DClinPsy</au><au>Streater, Amy, MSc</au><au>Whitaker, Christopher, MSc</au><au>Woods, Robert T., MA, MSc</au><au>Orrell, Martin, PhD, FRCPsych</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial</atitle><jtitle>Journal of the American Medical Directors Association</jtitle><addtitle>J Am Med Dir Assoc</addtitle><date>2015</date><risdate>2015</risdate><volume>16</volume><issue>1</issue><spage>63</spage><epage>70</epage><pages>63-70</pages><issn>1525-8610</issn><eissn>1538-9375</eissn><abstract>Abstract 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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25528281</pmid><doi>10.1016/j.jamda.2014.10.020</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0069-479X</orcidid><orcidid>https://orcid.org/0000-0003-3826-2711</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | acetylcholinesterase inhibitors Activities of Daily Living Aged Aged, 80 and over Cholinesterase Inhibitors - therapeutic use Cognitive stimulation therapy Cognitive Therapy - economics Cognitive Therapy - methods cost Cost-Benefit Analysis cost-effectiveness dementia Dementia - drug therapy Dementia - rehabilitation Female Humans Internal Medicine Male Medical Education Neuropsychological Tests Quality of Life randomized controlled trial Single-Blind Method Treatment Outcome |
| title | Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial |
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