Cognitive stimulation therapy for people with dementia

cost-effectiveness analysis

KNAPP, MARTIN PhD
THORGRIMSEN, LENE PhD
PATEL, ANITA MSc
SPECTOR, AIMEE PhD
HALLAM, ANGELA MSc, Scottish Executive
WOODS, BOB MSc
ORRELL, MARTIN PhD

Personal Social Services Research Unit, London School of Economics; and Centre for the Economics of Mental Health, Institute of Psychiatry, King's College London (KNAPP)
formerly Department of Mental Health Sciences, University College London (THORGRIMSEN)
Centre for the Economics of Mental Health, Institute of Psychiatry, King's College London (PATEL)
Department of Mental Health Sciences, University College London (SPECTOR)
Health and Community Care Research, Edinburgh (formerly Centre for the Economics of Mental Health, Institute of Psychiatry, King's College London) (HALLAM)
Dementia Services Development Centre, University of Bangor, Bangor (WOODS)
Department of Mental Health Sciences, University College London, UK (ORRELL)

Correspondence: Professor Martin Knapp, Personal Social Services Research Unit, London School of Economics, Houghton Street, London WC2A 2AE. Tel. +44 (0)20 7955 6225; email: [email protected]

Declaration of interest None.

Funding detailed in Acknowledgements.

(First received 28 February 2005, final revision 15 July 2005, accepted 30 November 2005)

British Journal of Psychiatry 188(6):p 574-580, June 2006.

Background

Psychological therapy groups for people with dementia are widely used, but their cost-effectiveness has not been explored.

Aims

To investigate the cost-effectiveness of an evidence-based cognitive stimulation therapy (CST) programme for people with dementia as part of a randomised controlled trial.

Method

A total of 91 people with dementia, living in care homes or the community, received a CST group intervention twice weekly for 8 weeks; 70 participants with dementia received treatment as usual. Service use was recorded 8 weeks before and during the 8-week intervention and costs were calculated. A cost-effectiveness analysis was conducted with cognition as the primary outcome, and quality of life as the secondary outcome. Cost-effectiveness acceptability curves were plotted.

Results

Cognitive stimulation therapy has benefits for cognition and quality of life in dementia, and costs were not different between the groups. Under reasonable assumptions, there is a high probability that CST is more cost-effective than treatment as usual, with regard to both outcome measures.

Conclusions

Cognitive stimulation therapy for people with dementia has effectiveness advantages over, and may be more cost-effective than, treatment as usual.