Economic costs and health-related quality of life associated with individual specific reminiscence: Results from the InspireD Feasibility Study

Abstract

Recent studies have focused on the use of technology to support reminiscence but there remains a dearth of research on the health costs and benefits associated with this intervention. The aim of this study was to estimate costs and quality of life associated with a home based, individual specific reminiscence intervention, facilitated by an iPad app for people living with dementia and their family carers, with a view to informing a future cost-effectiveness analysis. Use of community health and social care services, hospital services, prescribed medication and informal caregiving was assessed using an adapted version of the Client and Socio-Demographic Service Receipt Inventory (CSRI) at baseline and 3-month follow-up. Quality of life was assessed at baseline, 6-week and 3-month follow-up using the EQ5D, DEMQOL and DEMQOL proxy instruments. Results showed that average health and social care costs were £29,728 per person at baseline (T0) and £33,436 after 3 months (T2). Higher T2 costs were largely accounted for by higher informal caregiving costs. There was an overall increase in health-related quality of life over the duration of the intervention, although there were notable differences in index scores generated by the EQ5D (0.649, 0.652 and 0.719) and DEMQOL instruments (0.845, 0.968 and 0.901). The study concluded that a full cost-effectiveness analysis could incorporate a similar range of cost-categories with minor amendments to the CSRI to improve the accuracy of cost estimation. Furthermore, a larger sample size, randomisation and longer follow-up period are required to allow potential effects of the intervention to be realised and differences between intervention and control groups to be accurately detected.

Economic evaluations of electronic health interventions for people with age‐related cognitive impairment and their caregivers: A systematic review

“…Results showed that there was an overall increase in health‐related quality of life over the duration of the intervention. Recipients of e‐health had a significantly lower rate of emergency room visits (rate difference 9.5%, p = 0.048) and hospital stays (rate difference 11.4%, p = 0.01) over the 6‐month course of the intervention than usual care 42 …”

“…Six studies conducted cost‐consequence analysis 34,36,37,39,42,44 . A variety of health or non‐health‐related outcome indicators were selected for inclusion and were not limited to QALY.…”

“…Regarding the economic evaluation outcomes, six studies conducted a cost‐effectiveness analysis using ICER which was completed with PWACI or caregiver 35,40,41,43,45,46 . Six studies provided cost data in terms of health service utilization and some health outcome indicators 34,36,37,39,42,44 . In these articles, two manuscripts studied the health utilization services savings in PWACI, 36,39 and three articles studied the health utilization services savings in caregivers 34,37,44 .…”

Technology-Driven Solutions to Prompt Conversation, Aid Communication and Support Interaction for People With Dementia and Their Caregivers: A Systematic Literature Review

“…Of the eleven interventions identi ed using tablet-computer driven technologies, the most reviewed system was CIRCA, developed as a prototype to support and promote communication between PwD and their caregivers [13][14][15]. The software program is based on reminiscence, a therapy form that is widely recognized to contribute to actively engaging PwD and improve their wellbeing [16][17][18]. CIRCA is referred to as a "cognitive prosthesis" by its creators, as the system uses reminiscence as a basis for the conversation [3,13].…”

Virtual special issue – Using touchscreen tablets for virtual connection

“…The articles by McAllister et al (2017), Ferry et al (2018), and Ryan et al (2018) reported the results of digital apps that support reminiscences and meaningful engagement with carers. Finally, the article by Gibson et al (2016) is a scoping review that explored the provision of assistive technology products available for people with dementia.…”