Health Service and Population Research Department, King's College London, institute of Psychiatry, Psychology and Neuroscience, London, UK.
Health Service and Population Research Department, King's College London, institute of Psychiatry, Psychology and Neuroscience, London, UK.
Alzheimers Dement. 2019 Feb;15(2):282-291. doi: 10.1016/j.jalz.2018.08.010. Epub 2018 Nov 20.
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.
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.
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).
The WHELD intervention has clinical and economic benefits when used in residents with clinically significant agitation.
本研究旨在探讨，对于具有明显激越症状和痴呆的养老院居民，与常规治疗相比，优化干预是否是一种更具成本效益的选择，以改善其激越症状和生活质量。
在一项 69 家养老院 549 名居民参与的集群随机因子研究中进行了成本效益分析。每个集群被随机分配接受福祉和痴呆症患者健康（WHELD）干预或常规治疗 9 个月。评估了健康和社会护理成本、激越症状和生活质量的结果。
接受 WHELD 干预的居民激越症状和生活质量均有明显改善。WHELD 干预的额外成本被 TAU 组居民更高的健康和社会护理成本所抵消（平均差异，2103 英镑；95%置信区间，-13 至 4219）。
当用于具有明显激越症状的居民时，WHELD 干预具有临床和经济效益。
