Mancuso Mauro, Valentini Ilaria, Basile Michele, Bowen Audrey, Fordell Helena, Laurita Roberta, Möller Marika C, Williams Lindy J, Zoccolotti Pierluigi
Physical and Rehabilitative Medicine Unit, NHS-USL South-East Tuscany, Grosseto, Italy.
Tuscany Rehabilitation Clinic, Montevarchi (AR), Montevarchi, Italy.
J Neuropsychol. 2025 Mar;19(1):115-139. doi: 10.1111/jnp.12387. Epub 2024 Aug 8.
Acquired brain injuries (ABI), resulting from stroke or traumatic brain injury, cause a range of neuropsychological impairments and many patients continue to experience neuropsychological deficits years after onset. The increasing average age of the population highlights the importance of effective management strategies for the consequences of ABI. Despite the well-documented impact of rehabilitation interventions, the cost-effectiveness of neuropsychological rehabilitation remains largely unknown. This study conducted a scoping review to update the findings of Stolwyk et al. (Neuropsychological Rehabilitation, 2021, 31, 316), focusing on the economic evaluations of neuropsychological rehabilitation for individuals with ABI. Following the PIO framework, PRISMA ScR guidelines, and systematic review reporting checklist, the review screened 1027 articles and included eight studies published between 2019 and 2024. The studies encompassed either language rehabilitation or general neuropsychological programs, including neuropsychological interventions. The economic analyses, including two cost-effectiveness, five cost-utility, and one cost-benefit study, mostly adhered to CHEERS guidelines, enhancing the transparency and methodological rigour of their reporting. These studies demonstrated varying degrees of cost-effectiveness for interventions targeting post-stroke language disorders and neuropsychological rehabilitation for ABI, with significant cost savings and health benefits observed, particularly for home-based rehabilitation interventions. The included studies suffered from a short time horizon, limiting the ability to capture the long-term economic impacts and effectiveness of the interventions. Future research should focus on longer-term follow-up data and include broader search strategies to enhance understanding and optimise health care interventions. A comprehensive implementation of these economic analyses is crucial for informing policymakers, enabling them to introduce rehabilitative interventions based on solid evidence.
后天性脑损伤（ABI）由中风或创伤性脑损伤引起，会导致一系列神经心理障碍，许多患者在发病多年后仍存在神经心理缺陷。人口平均年龄的增长凸显了有效管理ABI后果的策略的重要性。尽管康复干预的影响已有充分记录，但神经心理康复的成本效益在很大程度上仍不为人知。本研究进行了一项范围综述，以更新斯托尔维克等人（《神经心理康复》，2021年，第31卷，第316页）的研究结果，重点关注针对ABI患者的神经心理康复的经济评估。遵循PIO框架、PRISMA ScR指南和系统综述报告清单，该综述筛选了1027篇文章，纳入了2019年至2024年发表的八项研究。这些研究涵盖语言康复或一般神经心理项目，包括神经心理干预。经济分析包括两项成本效益研究、五项成本效用研究和一项成本效益研究，大多遵循CHEERS指南，提高了报告的透明度和方法严谨性。这些研究表明，针对中风后语言障碍的干预措施和ABI的神经心理康复具有不同程度的成本效益，观察到显著的成本节约和健康效益，特别是对于家庭康复干预。纳入的研究存在研究期限短的问题，限制了捕捉干预措施长期经济影响和有效性的能力。未来的研究应侧重于长期随访数据，并采用更广泛的搜索策略，以增进理解并优化医疗保健干预措施。全面实施这些经济分析对于为政策制定者提供信息至关重要，使他们能够基于确凿证据引入康复干预措施。
