Table 3 Characteristics of articles comprising cognitive interventions
Study, country | Type of study and economic evaluation | Time horizon C: Cost H: Health outcome | Study population, Number of participants | IG: Intervention group CG: Control group | Outcome measures (measures of benefit) | Cost data; source | Perspective | Results |
|---|---|---|---|---|---|---|---|---|
Orgeta [27] UK, 2015 | RCT CEA CUA | C: 26 weeks H: 26 weeks | Community-dwelling PwDs of any type (MMSE ≥10) and family caregivers ▪ 356 randomized dyads ▪ 273 dyads completed the second-follow-up (76.7%) ▪ 264 dyads with complete case information for the cost analyses | IG: Home-based individual cognitive stimulation therapy administered by the caregiver up to three times a week over 25 weeks CG: CAU | Primary* ▪ Cognition: ADAS-Cog (PwD) ▪ Self-reported QoL: QoL-AD (PwD) ▪ QALY (carer) derived from the EQ-5D-3 L Secondary PwD* ▪ Quality of caregiver-patient relationship: QCPR | CSRI | (I) Health & social care perspective (II) Societal perspective | CST did neither improve cognition or QoL of PwDs, nor carers’ physical and mental health. Costs of the intervention were offset by some reductions in social care and other services. Considering the primary outcomes for PwDs, it seems that the intervention is not more cost-effective compared to CAU (from both perspectives). |
Woods [26] UK, 2012 | RCT CEA CUA | C: 10Â months H: 10Â months | Community-dwelling PwDs with mild or moderate dementia and a respective caregiver willing to participate â–ª 488 randomized dyads â–ª 350 dyads completed the study | IG: Weekly reminiscence groups attended by both caregiver and patient over a period of 12Â weeks followed by monthly maintenance sessions for a further 7Â months CG: CAU | Primary (CEA) â–ª QoL-AD (PwD) â–ª GHQ of caregivers Secondary (CUA) â–ª EQ-5D of both caregiver and PwD â–ª EQ-5D proxy rated by the caregivers | CSRI | Public sector, multiagency perspective (NHS and local governments) | Joint reminiscence groups for PwDs and their caregivers are unlikely to be cost-effective. Potential beneficial effects for PwDs are offset by raised anxiety and stress in their caregivers. |
D’Amico [21] UK, 2015 | RCT CEA CUA | C: 6 months H: 6 months | Persons with mild-to-moderate dementia according to the DSM-IV criteria and a score between 0.5 and 2.0 on the Clinical Dementia Rating ▪ 236 randomized participants ▪ 199 completed the second follow up at 6 months | IG: After all participants completed 7 weeks of standard cognitive stimulation therapy (CST), the intervention group received MCST for 24 weeks in addition to usual care CG: 7 weeks of standard cognitive stimulation therapy (CST) and afterwards CAU | Primary ▪ ADAS-Cog ▪ QoL-AD Secondary ▪ MMSE ▪ ADCS-ADL ▪ NPI ▪ EQ-5D-3 L (PwD self-report or proxy) ▪ QoL-AD (proxy) ▪ DEMQOL | CSRI completed by caregivers or center workers | (I) Health & social care perspective (II) Societal perspective | Maintenance CST appeared cost-effective when looking at self-rated QoL and cognition (MMSE) and proxy-rated QoL as secondary outcomes. CST in combination with AChEIs offered cost-effectiveness gains when outcome was measured as cognition. |