Costs of care in a mild‐to‐moderate Alzheimer clinical trial sample: Key resources and their determinants

Gustavsson, Anders; Cattelin, F; Jönsson, Linus

doi:10.1016/j.jalz.2010.06.002

Cited by 39 publications

(68 citation statements)

References 64 publications

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“…The cost of delivering the intervention will be calculated using time logs retained by interventionists of treatment and attention control groups that includetime spent in preparation and provision of respective interventions, and supervision and training and materials used. Healthcare utilization will be captured using the Resource Utilization in Dementia—Lite (RUD-Lite) (Gustavsson et al, 2010; Gustavsson et al, 2011; Neubauer et al, 2009; Wimo et al, 1998; Wimo et al, 2007; Wimo et al, 2010; Wimo et al, 2013) and the Service Use and Resource Form (SURF) (Rosenheck et al, 2006; Rosenheck et al, 2007; Schneider et al, 2001), questionnaires developed specifically for clinical trials involving persons with dementia. Utilization will be converted to cost by applying prevailing reimbursement rates and case mix-based costs (using DRGs) for inpatient stays.…”

Section: Discussionmentioning

confidence: 99%

Reducing neuropsychiatric symptoms in persons with dementia and associated burden in family caregivers using tailored activities: Design and methods of a randomized clinical trial

Gitlin

Piersol

Hodgson

et al. 2016

Contemporary Clinical Trials

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Among over 5 million people in the USA with dementia, neuropsychiatric symptoms (NPS) are almost universal, occurring across disease etiology and stage. If untreated, NPS can lead to significant morbidity and mortality including increased cost, distress, depression, and faster disease progression, as well as heightened burden on families. With few pharmacological solutions, , identifying nonpharmacologic strategies is critical. We describe a randomized clinical trial, the Dementia Behavior Study, to test the efficacy of an activity program to reduce significant existing NPS and associated caregiver burden at 3 and 6 months compared to a control group intervention. Occupational therapists deliver 8 in-home sessions over 3 months to assess capabilities and interests of persons with dementia, home environments, and caregiver knowledge, and readiness from which activities are developed and families trained in their use. Families learn to modify activities for future declines and use strategies to address care challenges. The comparison group controls for time and attention and involves 8 in-home sessions delivered by health educators who provide dementia education, home safety recommendations, and advanced care planning. We are randomizing 250 racially diverse families (person with dementia and primary caregiver dyads) recruited from community-based social services, conferences and media announcements. The primary outcome is change in agitation/aggression at 3 and 6 months. Secondary outcomes assess quality of life of persons with dementia, other behaviors, burden and confidence of caregivers, and cost effectiveness. If benefits are supported, this activity intervention will provide a clinically meaningful approach to prevent, reduce, and manage NPS.

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Section: Discussionmentioning

confidence: 99%

Reducing neuropsychiatric symptoms in persons with dementia and associated burden in family caregivers using tailored activities: Design and methods of a randomized clinical trial

Gitlin

Piersol

Hodgson

et al. 2016

Contemporary Clinical Trials

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“…In this questionnaire, caregiver time is evaluated by asking how much time is spent on activities of daily living (ADL), instrumental ADL, and supervision on an average caregiving day in the past 30 days. According to common practice [22], the total reported time was capped at maximum 18 h per day to avoid overestimation [23]. …”

Section: Design and Methodsmentioning

confidence: 99%

Factors Associated with the Caregivers’ Desire to Institutionalize Persons with Dementia: A Cross-Sectional Study

Vandepitte

Putman

Noortgate

et al. 2018

Dement Geriatr Cogn Disord

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Background/Aims: Dementia is one of the main reasons for institutionalization among the elderly. Few studies have explored factors associated with the caregivers’ (CG) desire to institutionalize (DTI) a person with dementia (PWD). The objective of this study is to identify modifiable and non-modifiable psychosocial and sociodemographic factors associated with a caregiver’s DTI. Methods: Cross-sectional data of 355 informal CG of community-dwelling PWD were analyzed. Several characteristics were identified in CG and PWD to be included in a multivariable regression model based on the purposeful selection method. Results: Positively modifiable associated factors were: higher CG burden, being affected by behavioral problems, and respite care use. Positively associated non-modifiable factors were: CG older age, being professionally active, and CG higher educational level. Cohabitation and change of professional situation were negatively associated. Conclusion: Although no causality can be assumed, several practical recommendations can be suggested. First of all, these results reconfirm the importance of multicomponent strategies, especially support aimed at decreasing burden and in learning coping strategies. Also, CG might benefit from information about support options, such as respite care services. Finally, special attention should be given to older and working CG. In the latter, flexible and adaptive working conditions might alleviate burden and therefore reduce the DTI of the PWD.

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“…A total of 47 studies reported economic data on the direct and indirect costs of AD for the seven selected countries; the remaining five studies reported aggregated international data [50][51][52][53][54]. Among the 47 studies, 17 primary source articles were identified in which cost component data were available and presented according to AD severity or patients' living conditions; two for France [55,56], four for Germany [7,[57][58][59], zero for Italy, three for the Netherlands [8,51,60], four for Spain [49,[61][62][63], two for the UK [64,65], and two for the USA [9,66].…”

Section: Economic (Direct and Indirect Costs)mentioning

confidence: 99%

Epidemiological and Economic Burden of Alzheimer's Disease: A Systematic Literature Review of Data across Europe and the United States of America

Takizawa

Thompson²,

Walsem³

et al. 2014

JAD

192

148

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Costs of care in a mild‐to‐moderate Alzheimer clinical trial sample: Key resources and their determinants

Cited by 39 publications

References 64 publications

Reducing neuropsychiatric symptoms in persons with dementia and associated burden in family caregivers using tailored activities: Design and methods of a randomized clinical trial

Reducing neuropsychiatric symptoms in persons with dementia and associated burden in family caregivers using tailored activities: Design and methods of a randomized clinical trial

Factors Associated with the Caregivers’ Desire to Institutionalize Persons with Dementia: A Cross-Sectional Study

Epidemiological and Economic Burden of Alzheimer's Disease: A Systematic Literature Review of Data across Europe and the United States of America

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