Improving the quality of life of care home residents with dementia: Cost-effectiveness of an optimized intervention for residents with clinically significant agitation in dementia

被引:15
|
作者
Romeo, Renee [1 ]
Zala, Darshan [1 ]
Knapp, Martin [2 ]
Orrell, Martin [3 ]
Fossey, Jane [4 ]
Ballard, Clive [5 ]
机构
[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Serv & Populat Res Dept, London, England
[2] London Sch Econ & Polit Sci, Personal Social Serv Res Unit, London, England
[3] Univ Nottingham, Inst Mental Hlth, Innovat Pk, Nottingham, England
[4] Oxford Hlth NHS Fdn Trust, Fulbrook Ctr, Psychol Serv, Oxford, England
[5] Kings Coll London, Wolfson Ctr Age Related Dis, Guys Campus, London, England
关键词
Alzheimer; Dementia; Costs; Care home; Nursing home; Agitation; Fees; SEVERE ALZHEIMERS-DISEASE; DOUBLE-BLIND; DONEPEZIL; PEOPLE; HEALTH; DEMQOL; EFFICACY; SAFETY; DRUGS;
D O I
10.1016/j.jalz.2018.08.010
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: To examine whether an optimized intervention is a more cost-effective option than treatment as usual (TAU) for improving agitation and quality of life in nursing home residents with clinically significant agitation and dementia. Methods: A cost-effectiveness analysis within a cluster-randomized factorial study in 69 care homes with 549 residents was conducted. Each cluster was randomized to receive either the Well-being and Health for people with Dementia (WHELD) intervention or TAU for nine months. Health and social care costs, agitation, and quality of life outcomes were evaluated. Results: Improvements in agitation and quality of life were evident in residents allocated to the WHELD intervention group. The additional cost of the WHELD intervention was offset by the higher health and social care costs incurred by TAU group residents (mean difference, 2103; pound 95% confidence interval, -13 to 4219). Discussion: The WHELD intervention has clinical and economic benefits when used in residents with clinically significant agitation. Crown Copyright (C) 2018 Published by Elsevier Inc. on behalf of the Alzheimer's Association. All rights reserved.
引用
收藏
页码:282 / 291
页数:10
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