TY - JOUR
T1 - Costs of Care of Agitation Associated With Dementia in 8 European Countries
T2 - Results From the RightTimePlaceCare Study
AU - Costa, Nadège
AU - Wübker, Ansgar
AU - De Mauléon, Adelaïde
AU - Zwakhalen, Sandra M.G.
AU - Challis, David
AU - Leino-Kilpi, Helena
AU - Rahm Hallberg, Ingalill
AU - Stephan, Astrid
AU - Zabalegui, Adelaida
AU - Saks, Kai
AU - Molinier, Laurent
AU - Wimo, Anders
AU - Vellas, Bruno
AU - Sauerland, Dirk
AU - Binot, Ingrid
AU - Soto, Maria E.
AU - RightTimePlaceCare consortium
PY - 2018
Y1 - 2018
N2 - Objective To estimate the additional societal costs for people living with dementia (PwD) with agitation in home care (HC) and institutional long-term care (ILTC) settings in 8 European countries. Design Cross-sectional data from the RightTimePlaceCare cohort. Setting HC and ILTC settings from 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, and England). Participants A total of 1997 PwD (1217 in HC group and 780 lived in an ILTC) and their caregivers. Main Outcome Measures Medical care, community care, and informal care were recorded using the Resource Utilization in Dementia (RUD) questionnaire. Agitation was assessed based on the agitation symptoms cluster defined by the presence of agitation and/or irritability and/or disinhibition and/or aberrant motor behavior items of the Neuropsychiatric Inventory Questionnaire (NPI-Q). Results Total monthly mean cost differences due to agitation were 445€ in the HC setting and 561€ in the ILTC setting (P =.01 and.02, respectively). Informal care costs were the main driver in the HC group (73% of total costs) and institutional care costs were the main driver in the ILTC group (53% of total costs). After adjustments, the log link generalized linear mixed model showed an association between agitation symptoms and an increase of informal care costs by 17% per month in HC setting (P <.05). Conclusion This study found that agitation symptoms have a substantial impact on informal care costs in the community care setting. Future research is needed to evaluate which strategies may be efficient by improving the cost-effectiveness ratio and reducing the burden associated with informal care in the management of agitation in PwD.
AB - Objective To estimate the additional societal costs for people living with dementia (PwD) with agitation in home care (HC) and institutional long-term care (ILTC) settings in 8 European countries. Design Cross-sectional data from the RightTimePlaceCare cohort. Setting HC and ILTC settings from 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, and England). Participants A total of 1997 PwD (1217 in HC group and 780 lived in an ILTC) and their caregivers. Main Outcome Measures Medical care, community care, and informal care were recorded using the Resource Utilization in Dementia (RUD) questionnaire. Agitation was assessed based on the agitation symptoms cluster defined by the presence of agitation and/or irritability and/or disinhibition and/or aberrant motor behavior items of the Neuropsychiatric Inventory Questionnaire (NPI-Q). Results Total monthly mean cost differences due to agitation were 445€ in the HC setting and 561€ in the ILTC setting (P =.01 and.02, respectively). Informal care costs were the main driver in the HC group (73% of total costs) and institutional care costs were the main driver in the ILTC group (53% of total costs). After adjustments, the log link generalized linear mixed model showed an association between agitation symptoms and an increase of informal care costs by 17% per month in HC setting (P <.05). Conclusion This study found that agitation symptoms have a substantial impact on informal care costs in the community care setting. Future research is needed to evaluate which strategies may be efficient by improving the cost-effectiveness ratio and reducing the burden associated with informal care in the management of agitation in PwD.
KW - agitation
KW - costs
KW - Dementia
KW - Europe
KW - informal care
KW - long-term care
UR - http://www.scopus.com/inward/record.url?scp=85039935155&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2017.10.013
DO - 10.1016/j.jamda.2017.10.013
M3 - Article
C2 - 29275939
AN - SCOPUS:85039935155
SN - 1525-8610
VL - 19
SP - 95.e1-95.e10
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 1
ER -
