Applied Health Technology, Department of Health, Blekinge Institute of Technology (BTH), Karlskrona, Sweden.
Health Economics Unit, Department of Clinical Sciences (Malmö), Lund University, Lund, Sweden.
J Alzheimers Dis. 2022;86(4):1629-1641. doi: 10.3233/JAD-215013.
A randomized controlled trial of the SMART4MD tablet application was conducted for persons with mild cognitive impairment (PwMCI) and their informal caregivers to improve or maintain quality of life.
The objective was to conduct economic evaluation of SMART4MD compared to standard care in Sweden from a healthcare provider perspective based on a 6-month follow-up period.
Three hundred forty-five dyads were enrolled: 173 dyads in the intervention group and 172 in standard care. The primary outcome measures for PwMCI and informal caregivers were quality-adjusted life years (QALY). The results are presented as incremental cost-effectiveness ratios, and confidence intervals are calculated using non-parametric bootstrap procedure.
For PwMCI, the mean difference in total costs between intervention and standard care was € 12 (95% CI: -2090 to 2115) (US$ = € 1.19) and the mean QALY change was -0.004 (95% CI: -0.009 to 0.002). For informal caregivers, the cost difference was - € 539 (95% CI: -2624 to 1545) and 0.003 (95% CI: -0.002 to 0.008) for QALY. The difference in cost and QALY for PwMCI and informal caregivers combined was -€ 527 (95% CI: -3621 to 2568) and -0.001 (95% CI: -0.008 to 0.006). Although generally insignificant differences, this indicates that SMART4MD, compared to standard care was: 1) more costly and less effective for PwMCI, 2) less costly and more effective for informal caregivers, and 3) less costly and less effective for PwMCI and informal caregivers combined.
The cost-effectiveness of SMART4MD over 6 months is inconclusive, although the intervention might be more beneficial for informal caregivers than PwMCI.
一项针对轻度认知障碍（MCI）患者及其非正式照护者的 SMART4MD 平板电脑应用程序的随机对照试验旨在提高或维持生活质量。
本研究旨在从医疗保健提供者的角度，对 SMART4MD 与瑞典标准护理进行 6 个月随访的经济性评估。
共纳入 345 对患者和照护者：干预组 173 对，标准护理组 172 对。主要结局指标为患者和照护者的生活质量调整生命年（QALY）。结果以增量成本效果比表示，置信区间采用非参数自举程序计算。
对于患者，干预组与标准护理组的总费用差异为 12 欧元（95%CI：-2090 至 2115）（美元=欧元 1.19），QALY 变化差异为-0.004（95%CI：-0.009 至 0.002）。对于照护者，成本差异为-539 欧元（95%CI：-2624 至 1545），QALY 差异为 0.003（95%CI：-0.002 至 0.008）。患者和照护者的成本和 QALY 综合差异为-527 欧元（95%CI：-3621 至 2568）和-0.001（95%CI：-0.008 至 0.006）。尽管差异通常无统计学意义，但这表明与标准护理相比，SMART4MD：1）对患者的成本更高，效果更差，2）对照护者的成本更低，效果更好，3）对患者和照护者的成本和效果都更低。
SMART4MD 在 6 个月时的成本效益不确定，尽管该干预措施对非正式照护者可能比患者更有益。
