维持性认知刺激疗法：一项随机对照试验中的经济学评价。
Maintenance cognitive stimulation therapy: an economic evaluation within a randomized controlled trial.
机构信息
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
出版信息
J Am Med Dir Assoc. 2015 Jan;16(1):63-70. doi: 10.1016/j.jamda.2014.10.020.
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.
背景
认知刺激疗法（CST）对于轻度至中度痴呆患者是有效且具有成本效益的，当每两周进行一次治疗并持续 7 周时效果最佳。
目的
研究在常规护理的基础上增加长期（维持）CST 是否具有成本效益。
方法
在多中心、单盲、实用随机对照试验中进行成本效益分析；对服用乙酰胆碱酯酶抑制剂（ACHEIs）的人群进行亚组分析。共有 236 名轻度至中度痴呆患者接受了为期 7 周的 CST 治疗。他们被随机分配到每周接受 CST 维持治疗并添加到常规护理中，或仅接受常规护理 24 周。
结果
尽管在 6 个月内获得的结果收益不大，但当将自我评估的生活质量作为主要结果，认知（MMSE）和代理评估的质量调整生命年来作为次要结果时，维持 CST 似乎具有成本效益。当以认知作为结果衡量标准时，CST 与 ACHEIs 联合使用具有成本效益。
结论
对于轻度至中度痴呆患者，继续进行 CST 可能具有成本效益。
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