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

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.

Keywords: Cognitive stimulation therapy; acetylcholinesterase inhibitors; cost; cost-effectiveness; dementia; randomized controlled trial.