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

Renee Romeo; Darshan Zala; Martin Knapp; Martin Orrell; Jane Fossey; Clive Ballard

doi:10.1016/j.jalz.2018.08.010

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

Alzheimers Dement. 2019 Feb;15(2):282-291. doi: 10.1016/j.jalz.2018.08.010. Epub 2018 Nov 20.

Authors

Renee Romeo¹, Darshan Zala², Martin Knapp³, Martin Orrell⁴, Jane Fossey⁵, Clive Ballard⁶

Affiliations

¹ Health Service and Population Research Department, King's College London, institute of Psychiatry, Psychology and Neuroscience, London, UK. Electronic address: renee.romeo@kcl.ac.uk.
² Health Service and Population Research Department, King's College London, institute of Psychiatry, Psychology and Neuroscience, London, UK.
³ Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
⁴ Institute of Mental Health, University of Nottingham, Innovation Park, Nottingham, UK.
⁵ Psychological Services, Oxford Health NHS Foundation Trust, Fulbrook Centre, Oxford, UK.
⁶ Wolfson Centre for Age Related Diseases, King's College London, Guy's Campus, London, UK.

PMID: 30470592
DOI: 10.1016/j.jalz.2018.08.010

Abstract

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; 95% confidence interval, -13 to 4219).

Discussion: The WHELD intervention has clinical and economic benefits when used in residents with clinically significant agitation.

Keywords: Agitation; Alzheimer; Care home; Costs; Dementia; Fees; Nursing home.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged, 80 and over
Cost-Benefit Analysis*
Dementia / complications*
Dementia / therapy
Female
Humans
Male
Nursing Homes / economics*
Psychomotor Agitation / therapy*
Quality of Life / psychology*

Grants and funding

RP-PG-0608-10133/DH_/Department of Health/United Kingdom