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Maintenance cognitive stimulation therapy: an economic evaluation within a randomized controlled trial.

Francesco d’Amico,A. Rehill,M. Knapp,E. Aguirre,H. Donovan,Z. Hoare,J. Hoe,I. Russell,A. Spector,Amy Streater,C. Whitaker,R. Woods,M. Orrell

Published 2015 in Journal of the American Medical Directors Association

ABSTRACT

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.

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