Trial reportApplied health economics and health policy2020
Cost-Effectiveness of Dementia Care Mapping in Care-Home Settings: Evaluation of a Randomised Controlled Trial.
Trial report in Applied health economics and health policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Cost-Effectiveness of Non-pharmacological Interventions for Mild Cognitive Impairment and Dementia: A Systematic Review of Economic Evaluations and a Review of Reviews.PharmacoEconomics - open · 2023Pooled it
- The value of supportive care: A systematic review of cost-effectiveness of non-pharmacological interventions for dementia.PloS one · 2023Pooled it
- Assessing the psychometric performance of EQ-5D-5L in dementia: a systematic review.Health and quality of life outcomes · 2022Pooled it
- A multidomain decision support tool to prevent falls in older people: the FinCH cluster RCT.Health technology assessment (Winchester, England) · 2022Trial
- Multifactorial falls prevention programme compared with usual care in UK care homes for older people: multicentre cluster randomised controlled trial with economic evaluation.BMJ (Clinical research ed.) · 2021Trial
- Dementia Care Mapping™ to reduce agitation in care home residents with dementia: the EPIC cluster RCT.Health technology assessment (Winchester, England) · 2020Trial
- Evidence-based care pathways for people with dementia and neurodegenerative disorders in Europe: a systematic review of models, integration of digital technologies, and quality indicators.Frontiers in medicine · 2026Review
- Understanding Pathways into Care-homes using Data (UnPiCD study): a two-part model to estimate inpatient and care-home costs using national linked health and social care data.BMC health services research · 2024Article
- Article
- Inter-rater reliability of care home staff's proxy judgements with residents' assessments of their own health-related quality of life: an analysis of the PATCH trial EQ-5D data.Age and ageing · 2021Article
- Cost-effectiveness of a telehealth intervention for in-home dementia care support: Findings from the FamTechCare clinical trial.Research in nursing & health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundBehaviours such as agitation impact on the quality of life of care-home residents with dementia and increase healthcare use. Interventions to prevent these behaviours have little evidence supporting their effectiveness or cost-effectiveness. We conducted an economic evaluation alongside a trial assessing Dementia Care Mapping™ (DCM) versus usual care for reducing agitation, and highlight methodological challenges of conducting evaluations in this population and setting.
methodsRCT data over 16 months from English care-home residents with dementia (intervention n = 418; control n = 308) were analysed. We conducted a cost-utility analysis from the healthcare provider perspective. We gathered resource use and utility (EQ-5D-5L and DEMQoL-Proxy-U) from people living with dementia and proxy informants (staff and relatives). Data were analysed using seemingly unrelated regression, accounting for care-home clustering and bootstrapping used to capture sampling uncertainty.
resultsCosts were higher in the intervention arm than in the control arm (incremental = £1479) due in part to high cost outliers. There were small QALY gains (incremental = 0.024) in favour of DCM. The base-case ICER (£64,380 per QALY) suggests DCM is not cost-effective versus usual care. With the exception of analyses excluding high cost outliers, which suggested a potential for DCM to be cost-effective, sensitivity analyses corroborated the base-case findings. Bootstrapped estimates suggested DCM had a low probability (< 0.20 where λ = £20,000) of being cost-effective versus control.
conclusionDCM does not appear to be a cost-effective intervention versus usual care in this group and setting. The evaluation highlighted several methodological challenges relating to validity of utility assessments, loss to follow-up and compliance. Further research is needed on handling high-cost individuals and capturing utility in this group. ISRCTN reference 82288852.
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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.