Evidence map›Paper›PMID 27739182›Full record

Trial reportInternational journal of geriatric psychiatry2017

Cost-effectiveness of donepezil and memantine in moderate to severe Alzheimer's disease (the DOMINO-AD trial).

Martin Knapp, Derek King, Renée Romeo, Jessica Adams, Ashley Baldwin, Clive Ballard, Sube Banerjee, Robert Barber, Peter Bentham, Richard G Brown and 15 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of geriatric psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 5 pooled it
4.4field-weighted citation impact, top 5% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 63 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. How relevant are social costs in economic evaluations? The case of Alzheimer's disease.The European journal of health economics : HEPAC : health economics in prevention and care · 2019
    Pooled it
  4. Memantine for dementia.The Cochrane database of systematic reviews · 2019
    Pooled it
  5. Donepezil for dementia due to Alzheimer's disease.The Cochrane database of systematic reviews · 2018
    Pooled it
  6. Trial
  7. Trial
  8. Review
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  10. Article
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  12. Article
  13. Review
  14. Review
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  20. Economics and mental health: the current scenario.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 17 institutions in 1 country.

Martin KnappPersonal Social Services Research Unit, London School of Economics and Political Science, London, UK.
Derek KingPersonal Social Services Research Unit, London School of Economics and Political Science, London, UK.
Renée RomeoKing's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Jessica AdamsDepartment of Biostatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Ashley BaldwinFive Boroughs Partnership NHS Foundation Trust, Warrington, UK.
Clive BallardWolfson Centre for Age Related Disorders, King's College, London, London, UK.
Sube BanerjeeBrighton and Sussex Medical School, University of Sussex, Brighton, UK.
Robert BarberCampus for Ageing and Vitality, Newcastle upon Tyne, UK.
Peter BenthamBirmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK.
Richard G BrownDepartment of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Alistair BurnsFaculty of Medical and Human Sciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
Tom DeningDivision of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
David FindlayStratheden Hospital, Cupar, Scotland, UK.
Clive HolmesFaculty of Medicine, University of Southampton, Southampton, UK.
Tony JohnsonMedical Research Council Clinical Trials Unit, University College London, London, UK.
Robert JonesDivision of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
Cornelius KatonaDivision of Psychiatry, University College London, London, UK.
James LindesayHealth Sciences, University of Leicester, Leicester, UK.
Ajay MacharouthuAyrshire and Arran NHS, University Hospital Crosshouse, Kilmarnock, UK.
Ian McKeithInstitute for Ageing, University of Newcastle, Newcastle upon Tyne, UK.
Rupert McShaneOxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
John T O'BrienDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
Patrick P J PhillipsMedical Research Council Clinical Trials Unit, University College London, London, UK.
Bart SheehanOxford University Hospitals NHS Foundation Trust, Oxford, UK.
Robert HowardDivision of Psychiatry, University College London, London, UK.
King's College London · GBUniversity College London · GBLondon School of Economics and Political Science · GBNewcastle Hospitals - Campus for Ageing and Vitality · GBUniversity of Nottingham · GBBirmingham and Solihull Mental Health NHS Foundation Trust · GBMedical Research Council · GBNHS Ayrshire and Arran · GBNorth West Boroughs Healthcare NHS Foundation Trust · GBOxford Health NHS Foundation Trust · GBOxford University Hospitals NHS Trust · GBStratheden Hospital · GBUniversity of Cambridge · GBUniversity of Leicester · GBUniversity of Manchester · GBUniversity of Southampton · GBUniversity of Sussex · GB

Funding

Medical Research Council G0600989Medical Research Council MC_UU_12023/30
6 · The paper itself

Abstract

objectiveMost investigations of pharmacotherapy for treating Alzheimer's disease focus on patients with mild-to-moderate symptoms, with little evidence to guide clinical decisions when symptoms become severe. We examined whether continuing donepezil, or commencing memantine, is cost-effective for community-dwelling, moderate-to-severe Alzheimer's disease patients.

methodsCost-effectiveness analysis was based on a 52-week, multicentre, double-blind, placebo-controlled, factorial clinical trial. A total of 295 community-dwelling patients with moderate/severe Alzheimer's disease, already treated with donepezil, were randomised to: (i) continue donepezil; (ii) discontinue donepezil; (iii) discontinue donepezil and start memantine; or (iv) continue donepezil and start memantine.

resultsContinuing donepezil for 52 weeks was more cost-effective than discontinuation, considering cognition, activities of daily living and health-related quality of life. Starting memantine was more cost-effective than donepezil discontinuation. Donepezil-memantine combined is not more cost-effective than donepezil alone.

conclusionsRobust evidence is now available to inform clinical decisions and commissioning strategies so as to improve patients' lives whilst making efficient use of available resources. Clinical guidelines for treating moderate/severe Alzheimer's disease, such as those issued by NICE in England and Wales, should be revisited. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.

Indexed as

Activities of Daily LivingAgedAged, 80 and overAlzheimer DiseaseCholinesterase InhibitorsCognitionCost-Benefit AnalysisDonepezilDouble-Blind MethodEnglandFemaleHealth Care CostsHumansIndansMemantinePiperidinesCholinesterase InhibitorsDonepezilIndansMemantinePiperidinesAlzheimer's diseasecost-effectivenessdonepezilmemantine

Identifiers

PMID27739182
PMCPMC5724694
OpenAlexW2513465760

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.