Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis

TLDR

Psychological therapy groups for people with dementia are widely used, but their cost‑effectiveness has not been explored. The study investigates the cost‑effectiveness of an evidence‑based cognitive stimulation therapy (CST) programme for people with dementia in a randomized controlled trial. The trial enrolled 91 dementia patients (care homes or community) who received CST twice weekly for 8 weeks, compared to 70 receiving treatment as usual; service use was recorded before and during the intervention, costs calculated, and a cost‑effectiveness analysis was performed using cognition and quality‑of‑life outcomes with acceptability curves plotted. CST improves cognition and quality of life without increasing costs, and is highly likely to be more cost‑effective than treatment as usual.

Abstract

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.