Evidence map›Paper›PMID 28295134›Full record

Trial reportJournal of the American Geriatrics Society2017

Impact of the REACH II and REACH VA Dementia Caregiver Interventions on Healthcare Costs.

Linda O Nichols, Jennifer Martindale-Adams, Carolyn W Zhu, Erin K Kaplan, Jeffrey K Zuber, Teresa M Waters

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 pooled it
11.3field-weighted citation impact, top 2% 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

25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Review
  6. Article
  7. Article
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  15. Article
  16. Change Over Time in Caregiving Networks for Older Adults With and Without Dementia.The journals of gerontology. Series B, Psychological sciences and social sciences · 2020
    Article
  17. Article
  18. The costs of dementia subtypes to California Medicare fee-for-service, 2015.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2019
    Article
  19. Observational
  20. The caregiving phenomenon and caregiver participation in dementia.Scandinavian journal of caring sciences · 2019
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Linda O NicholsVeterans Affairs Medical Center, Memphis, Tennessee.
Jennifer Martindale-AdamsVeterans Affairs Medical Center, Memphis, Tennessee.
Carolyn W ZhuDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Erin K KaplanDepartment of Economics, Rhodes College, Memphis, Tennessee.
Jeffrey K ZuberVeterans Affairs Medical Center, Memphis, Tennessee.
Teresa M WatersDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
University of Tennessee Health Science Center · USJames J. Peters VA Medical Center · USRhodes College · US

Funding

Effect of Dementia Caregiver Interventions on Healthcare CostR01AG046224 · NIA · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI NICHOLS, LINDA O. · 2013 to 2015
$592k
NIA NIH HHS R01 AG046224
6 · The paper itself

Abstract

objectiveExamine caregiver and care recipient healthcare costs associated with caregivers' participation in Resources for Enhancing Alzheimer's Caregivers Health (REACH II or REACH VA) behavioral interventions to improve coping skills and care recipient management.

designRCT (REACH II); propensity-score matched, retrospective cohort study (REACH VA).

settingFive community sites (REACH II); 24 VA facilities (REACH VA).

participantsCare recipients with Alzheimer's disease and related dementias (ADRD) and their caregivers who participated in REACH II study (analysis sample of 110 caregivers and 197 care recipients); care recipients whose caregivers participated in REACH VA and a propensity matched control group (analysis sample of 491). MEASUREMENTS: Previously collected data plus Medicare expenditures (REACH II) and VA costs plus Medicare expenditures (REACH VA).

resultsThere was no increase in VA or Medicare expenditures for care recipients or their caregivers who participated in either REACH intervention. For VA care recipients, REACH was associated with significantly lower total VA costs of care (33.6%). VA caregiver cost data was not available.

conclusionIn previous research, both REACH II and REACH VA have been shown to provide benefit for dementia caregivers at a cost of less than $5/day; however, concerns about additional healthcare costs may have hindered REACH's widespread adoption. Neither REACH intervention was associated with additional healthcare costs for caregivers or patients; in fact, for VA patients, there were significantly lower healthcare costs. The VA costs savings may be related to the addition of a structured format for addressing the caregiver's role in managing complex ADRD care to an existing, integrated care system. These findings suggest that behavioral interventions are a viable mechanism to support burdened dementia caregivers without additional healthcare costs.

Indexed as

Adaptation, PsychologicalAgedCaregiversDementiaDisease ManagementFemaleHealth Care CostsHumansInsurance Claim ReviewMaleMedicarePropensity ScoreRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransAlzheimer's diseasecaregiverscostdementiaexpenditureshealthcare utilization

Identifiers

PMID28295134
PMCPMC5435565
OpenAlexW2600398937

What OpenQuestion holds

Textmetadata
LicenceTDM
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.