Cost–utility analysis of adapted problem adaptation therapy for depression in mild-to-moderate dementia caused by Alzheimer's disease: PATHFINDER randomised controlled trial
2024

Cost-utility analysis of adapted problem adaptation therapy for depression in dementia

Sample size: 336 publication 10 minutes Evidence: moderate

Author Information

Author(s): Panca Monica, Howard Robert, Cort Elizabeth, Rawlinson Charlotte, Gould Rebecca L., Wiegand Martin, Downey Anne Marie, Banerjee Sube, Fox Chris, Harwood Rowan, Livingston Gill, Moniz-Cook Esme, Russell Gregor, Thomas Alan, Wilkinson Philip, Freemantle Nick, Hunter Rachael Maree

Primary Institution: Comprehensive Clinical Trials Unit, University College London, UK

Hypothesis

This study aims to evaluate the cost-effectiveness of an intervention for depression in mild and moderate dementia caused by Alzheimer's disease.

Conclusion

The adapted PATH intervention for people with dementia and depression resulted in cost savings and improved quality of life compared to treatment as usual, but these improvements were not statistically significant.

Supporting Evidence

  • The adapted PATH intervention was associated with a mean difference in QALYs of 0.027.
  • At a cost-effectiveness threshold of £20,000 per QALY gained, there was a 74% probability of the adapted PATH being cost-effective from the health and social care perspective.
  • The mean cost of the adapted PATH intervention was estimated at £1141 per participant.
  • Participants in the adapted PATH arm reported fewer contacts with community practitioners over the 12 months.

Takeaway

This study looked at a therapy to help people with dementia who are also feeling sad. It found that the therapy might save money and help people feel better, but the results weren't strong enough to be sure.

Methodology

Participants were randomly assigned to receive either the adapted PATH intervention plus usual care or usual care alone, with health and social care resource use and quality of life data collected at multiple follow-up points.

Potential Biases

There is a risk of bias due to missing data and the potential influence of COVID-19 on outcomes.

Limitations

The study faced challenges with missing data and the impact of COVID-19 on service delivery and participant responses.

Participant Demographics

Participants had a median age of 78 years, were predominantly female (60%), and had mild to moderate dementia due to Alzheimer's disease.

Statistical Information

P-Value

p=0.011

Confidence Interval

95% CI −£1942 to £1793

Digital Object Identifier (DOI)

10.1192/bjo.2024.775

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