Table 4 Characteristics of articles on psychological and behavioral therapies
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 |
|---|---|---|---|---|---|---|---|---|
Spector [25] UK, 2015 | RCT cost analysis | C: 6 months H: 6 months | Community-dwelling patients with mild-to-moderate dementia and anxiety (N = 50) ▪ 50 randomized participants ▪ 38 participants completed second follow-up assessment | IG: Ten-session cognitive-behavioral therapy for anxiety in dementia CG: CAU | Primary ▪ RAID Secondary ▪ CSDD ▪ QoL-AD (self-reported) ▪ NPI ▪ HADS ▪ MMSE ▪ QCPR | CSRI | Health and social care perspective | Significant improvements in depression. CBT found to be cost neutral. |
Laakkonen [24] Finland, 2016 | RCT CEA | C: 24 months H: 9 months | Community-dwelling PwDs (shortly after the diagnosis) and their spouses ▪ 136 randomized dyads ▪ 134 completed the follow-up assessment after 9 months | IG: Self-management group rehabilitation for PwDs and their spouses; enhancement of self-efficacy and problem solving skills CG: CAU and the study nurses gave participants in the control group oral and written advice on nutrition and exercise | Primary ▪ HRQoL: 15D (PwD) ▪ RAND-36 (caregiver) ▪ SCQ | Resource utilization of health and social services was retrieved from central registers and medical records | Health and social care perspective | Improvement of caregivers’ HRQoL and the cognitive function of the PwD without increasing total costs. |
Søgaard [22] Denmark, 2014 | RCT CUA | C: 3 years H: 3 years | Community-dwelling persons with a diagnosis of AD, mixed AD diagnosis and vascular disease or dementia with Lewy bodies within the past 12 months, MMSE ≥20 and a primary caregiver willing to participate ▪ 330 randomized dyads ▪ 195 dyads in the complete case analysis | IG: Intensive, multicomponent, semi-tailored psychosocial intervention program with counselling, education and support CG: The control group was informed about available support programs in their respective community | ▪ Patient: EQ-5D proxy-rated by the caregiver ▪ Caregiver: self-rated EQ-5D | RUD and register data from national registries | Societal perspective | The psychosocial intervention is unlikely to be cost-effective since it did not generate additional QALY and it led to higher average usage of informal care. The provision of the intervention was estimated to incur an additional average cost of €3,401. Non-statistically significant cost savings were observed for the healthcare sector and for nursing home placements, whereas higher costs were observed for informal care. |