Evidence map›Paper›PMID 18171718›Full record

Trial reportBMJ (Clinical research ed.)2008

Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study.

Maud J L Graff, Eddy M M Adang, Myrra J M Vernooij-Dassen, Joost Dekker, L Jönsson, Marjolein Thijssen, Willibrord H L Hoefnagels, Marcel G M Olde Rikkert

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01117285 (Implementation and Evaluation of an Effective Community Occupational Therapy in Dementia), which is not on this map. Cited by 83 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 17 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01117285 naunknown statusnot on this mapstarted 2009, after this paper: background citation

Implementation and Evaluation of an Effective Community Occupational Therapy in Dementia (COTiD) Program

TypeinterventionalSponsorZonMw: The Netherlands Organisation for Health Research and DevelopmentRan2009 to 2011Enrolled180ConditionsDementiaArms3-day post-graduate course, Combined implementation strategy
3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 17 syntheses or guidelines pooled it.

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  13. Case management approaches to home support for people with dementia.The Cochrane database of systematic reviews · 2015
    Pooled it
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  15. Cognitive reframing for carers of people with dementia.The Cochrane database of systematic reviews · 2011
    Pooled it
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  17. Subjective barriers to prevent wandering of cognitively impaired people.The Cochrane database of systematic reviews · 2000
    Pooled it
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23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Maud J L GraffAlzheimer Centre Nijmegen, Department of Occupational Therapy 897, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, Netherlands. m.graff@pmd.umcn.nl
Eddy M M Adang
Myrra J M Vernooij-Dassen
Joost Dekker
L Jönsson
Marjolein Thijssen
Willibrord H L Hoefnagels
Marcel G M Olde Rikkert

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the cost effectiveness of community based occupational therapy compared with usual care in older patients with dementia and their care givers from a societal viewpoint.

designCost effectiveness study alongside a single blind randomised controlled trial.

settingMemory clinic, day clinic of a geriatrics department, and participants' homes. Patients 135 patients aged > or =65 with mild to moderate dementia living in the community and their primary care givers.

intervention10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision.

main outcome measuresIncremental cost effectiveness ratio expressed as the difference in mean total care costs per successful treatment (that is, a combined patient and care giver outcome measure of clinically relevant improvement on process, performance, and competence scales) at three months after randomisation. Bootstrap methods used to determine confidence intervals for these measures.

resultsThe intervention cost 1183 euros (848 pounds sterling, $1738) (95% confidence interval 1128 euros (808 pounds sterling, $1657) to 1239 euros (888 pounds sterling, $1820)) per patient and primary care giver unit at three months. Visits to general practitioners and hospital doctors cost the same in both groups but total mean costs were 1748 euros (1279 pounds sterling, $2621) lower in the intervention group, with the main cost savings in informal care. There was a significant difference in proportions of successful treatments of 36% at three months. The number needed to treat for successful treatment at three months was 2.8 (2.7 to 2.9).

conclusionsCommunity occupational therapy intervention for patients with dementia and their care givers is successful and cost effective, especially in terms of informal care giving.

Indexed as

AgedAmbulatory CareCaregiversCommunity Health ServicesCost-Benefit AnalysisDementiaFemaleHome Care ServicesHospitalizationHumansMaleNetherlandsOccupational TherapySingle-Blind MethodTreatment Outcome

Identifiers

PMID18171718
PMCPMC2206302

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.