Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-17T00:19:43.906Z Has data issue: false hasContentIssue false
  • English
  • Français

A systematic review of the cost-effectiveness of interventions for supporting informal caregivers of people with dementia residing in the community

Published online by Cambridge University Press:  04 August 2011

Carys Jones ,
Rhiannon Tudor Edwards  and
Barry Hounsome
Carys Jones*
Affiliation:
Centre for Health Economics and Medicines Evaluation, IMSCaR, College of Health and Behavioural Sciences, Bangor University, Gwynedd, Wales, UK
Rhiannon Tudor Edwards
Affiliation:
Centre for Health Economics and Medicines Evaluation, IMSCaR, College of Health and Behavioural Sciences, Bangor University, Gwynedd, Wales, UK
Barry Hounsome
Affiliation:
Centre for Health Economics and Medicines Evaluation, IMSCaR, College of Health and Behavioural Sciences, Bangor University, Gwynedd, Wales, UK
*
Correspondence should be addressed to: Carys Jones, Centre for Health Economics and Medicines Evaluation, IMSCaR, College of Health and Behavioural Sciences, Dean Street Building, Bangor University, Gwynedd, LL57 1UT, UK. Phone: (+44) 01248 382483. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Dementia places a huge demand on healthcare services; however, a large proportion of the cost is borne by informal caregivers. With the number of people affected by dementia set to increase in the future, there is a need for research to consider the effects of interventions on informal caregivers as well as on the individuals with dementia. This paper seeks to systematically review the existing evidence on the cost-effectiveness of interventions to support informal caregivers of people with dementia residing in the community.

Methods: A range of electronic databases was searched. Studies were included if both costs and outcome measures for informal caregivers of people with dementia residing in the community were reported for an intervention. Both pharmacological and non-pharmacological interventions were included. Quality of study was assessed using the Drummond ten-item checklist for economic evaluations and results were presented through narrative synthesis.

Results: Twelve studies were included in the review; of these only four reported a significant difference in the outcome measure for caregivers.

Conclusions: At present few published studies report costs in enough detail to provide evidence of the effectiveness and cost-effectiveness of interventions for supporting caregivers. Future trials need to collect caregiver data alongside patient data in order to increase the evidence base for intervention effectiveness. Further research is required to establish the effectiveness and cost-effectiveness of both pharmacological and non-pharmacological approaches.

Keywords

quality of lifecarersAlzheimer's diseasehealth economicsmeasurement
Type
Review Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 6 - 18
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barrett, A., Roques, T., Small, M. and Smith, R. D. (2006). Rationing: how much will Herceptin really cost? BMJ, 333, 1188–1120.Google Scholar
Brodaty, H., Green, A. and Koschera, A. (2003). Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657–664.Google Scholar
Challis, D., von Abendorff, R., Brown, P., Chesterman, J. and Hughes, J. (2002). Care management, dementia care and specialist mental health services: an evaluation. International Journal of Geriatric Psychiatry, 17, 315–325.Google Scholar
Charlesworth, G., Shepstone, L., Wilson, E., Thalanany, M., Mugford, M. and Poland, F. (2008). Does befriending by trained lay workers improve psychological well-being and quality of life for carers of people with dementia, and at what cost? A randomised controlled trial, Health Technology Assessment, 12 (4), 1–78.Google Scholar
Courtney, C. et al. (2004). Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomised double-blind trial. Lancet, 363, 2105–2115.Google Scholar
Department of Health (2010). Recognised, Valued and Supported: Next Steps for the Carers Strategy. London: Department of Health.Google Scholar
Drummond, M., Mohide, E., Tew, M., Streiner, D., Pringle, D. and Gilbert, J. (1991). Economic evaluation of a support program for caregivers of demented elderly. International Journal of Technology Assessment in Health Care, 7, 2, 209–219.Google Scholar
Drummond, M., Sculpher, M., Torrance, G. W., O'Brien, B. J. and Stoddart, G. L. (2005). Methods for the Economic Evaluation of Health Care Programmes, 3rd edn, Oxford University Press.Google Scholar
Engelhardt, J. B., Kisiel, T., Nicholson, J., Mulichak, L., DeMatteis, J. and Tobin, D. R. (2008). Impact of a care coordination and support strategic partnership on clinical outcomes. Home Healthcare Nurse, 26, 3, 166–172.Google Scholar
Feldman, H. et al. (2003). Efficacy of donepezil on maintenance of activities of daily living in patients with moderate to severe Alzheimer's disease and the effect on caregiver burden. Journal of the American Geriatrics Society, 51, 737–744.Google Scholar
Feldman, H. et al. (2004). Economic evaluation of donepezil in moderate to severe Alzheimer disease. Neurology, 63, 644–650.Google Scholar
Gaugler, J. E., Zarit, S. H., Townsend, A., StephensM-A., P. M-A., P. and Greene, R. (2003). Evaluating community-based programs for dementia caregivers: the cost implications of adult day services. Journal of Applied Gerontology, 22, 118–133.Google Scholar
Getsios, D., Blume, S., Ishak, K. J. and Maclaine, G. D. (2010). Cost effectiveness of donepezil in the treatment of mild to moderate Alzheimer's disease: a UK evaluation using discrete-event simulation. PharmacoEconomics, 28, 411–427.Google Scholar
Graff, M. J. L., Vernooij-Dassen, M. J. M., Thijssen, M., Dekker, J., Hoefnagels, W. H. L. and Rikkert, M. G. M. O. (2006). Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. BMJ, 333, 7580, 1196.Google Scholar
Graff, M. J. L. et al. (2008). Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. BMJ, 336, 7636, 134–138.Google Scholar
Joling, K. J. et al. (2008). (Cost)-effectiveness of family meetings on indicated prevention of anxiety and depressive symptoms and disorders of primary family caregivers of patients with dementia: design of a randomized controlled trial. BMC Geriatrics, 8, 2.Google Scholar
Luengo-Fernandez, R., Leal, J. and Gray, A. (2010). Dementia 2010. The Economic Burden of Dementia and Associated Research Funding in the United Kingdom. Cambridge: Alzheimer's Research Trust.Google Scholar
Martikainen, J., Valtonen, H. and Pirttila, T. (2004). Potential cost-effectiveness of a family-based program in mild Alzheimer's disease patients. Health Economics in Prevention and Care, 5, 136–142.Google Scholar
Neumann, P. J. et al. (1999). Cost-effectiveness of donepezil in the treatment of mild or moderate Alzheimer's disease. Neurology, 52, 1138–1145.Google Scholar
NICE (2007). Dementia: Supporting People with Dementia and their Carers in Health and Social Care. London: National Institute for Health and Clinical Excellence and Social Care Institute for Excellence.Google Scholar
NICE (2008). Guide to the Methods of Technology Appraisal. London: National Institute for Health and Clinical Excellence.Google Scholar
NICE (2009). Donepezil, Galantamine, Rivastigmine (Review) and Memantine for the Treatment of Alzheimer's Disease (Amended). London: National Institute for Health and Clinical Excellence.Google Scholar
Roberts, J. et al. , (1999). Problem-solving counseling for caregivers of the cognitively impaired: effective for whom? Nursing Research, 48, 162–172.Google Scholar
Wilson, E. et al. (2009). Befriending carers of people with dementia: a cost utility analysis, International Journal of Geriatric Psychiatry, 24, 610–623.Google Scholar
Wimo, A. and Prince, M. (2010). Alzheimer's Disease International World Alzheimer Report 2010: The Global Economic Impact of Dementia, London: Alzheimer's Disease International.Google Scholar
Woods, R. T. et al. (2009). Reminiscence groups for people with dementia and their family carers: pragmatic eight-centre randomised trial of joint reminiscence and maintenance versus usual treatment: a protocol. Trials, 10, 64.Google Scholar
Supplementary material: File

Jones Supplementary Table

Table S1: Quality assessment of included studies

Download Jones Supplementary Table(File)
File 51.7 KB