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

D'Amico, F., Rehill, A., Knapp, M. , Aguirre, E., Donovan, H., Hoare, Z., Hoe, J., Russell, I., Spector, A., Streater, A., Whitaker, C., Woods, R.T. & Orrell, M. (2015). Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial. Journal of the American Medical Directors Association, 16(1), pp. 63-70. doi: 10.1016/j.jamda.2014.10.020

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.

Publication Type:	Article
Publisher Keywords:	Cognitive stimulation therapy, dementia, cost, cost-effectiveness, randomized controlled trial, acetylcholinesterase inhibitors
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RT Nursing
Departments:	School of Health & Psychological Sciences > Nursing