FindMyApps 电子健康干预与常规数字护理的成本效益:随机对照试验结果。

IF 2.8 3区 医学 Q3 GERIATRICS & GERONTOLOGY
Aging & Mental Health Pub Date : 2024-11-01 Epub Date: 2024-05-06 DOI:10.1080/13607863.2024.2345128
David P Neal, Matej Kucera, Barbara C van Munster, Teake P Ettema, Karin Dijkstra, Majon Muller, Rose-Marie Dröes, Judith E Bosmans
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引用次数: 0

摘要

目的:尽管人们对电子健康干预措施的兴趣与日俱增,但其在提高痴呆症患者及其护理人员生活质量方面的成本效益仍不明确。本研究评估了 "FindMyApps "干预措施与 "数字照护 "干预措施的成本效益。FindMyApps旨在帮助痴呆症患者及其护理人员找到并学会使用平板电脑应用程序,这些应用程序可帮助痴呆症患者参与社会活动和自我管理,并增强护理人员的能力感:进行了一项随机对照试验(荷兰试验登记 NL8157),试验对象包括轻度认知障碍(MCI)或轻度痴呆症患者及其非正规护理人员(FindMyApps n = 76,数字照护 n = 74)。根据 EQ-5D-5L 数据和荷兰效用评分标准、社会参与(马斯特里赫特社会参与概况)和生活质量(成人社会护理成果工具包)计算,MCI/痴呆症患者的成果为质量调整生命年(QALYs),护理者的成果为质量调整生命年和能力感(简短能力感问卷)。社会成本采用 RUD-lite 工具和荷兰成本计算指南收集的数据进行计算。采用多重估算法填补缺失的成本和效果数据。采用引导式多层次模型估算增量社会总成本和组间增量效应,然后计算增量成本效益比(ICER)。还估算了成本效益可接受性曲线:在FindMyApps组中,护理人员的SSCQ评分明显高于普通护理(n=150,平均差异=0.75,95% CI [0.14,1.38])。其他结果在组间无明显差异。痴呆症患者的社会总成本无显著差异,n = 150,平均差异 = 774 欧元,95%CI [-2.643, .,079] 。与普通护理相比,FindMyApps 组护理人员的社会总成本明显较低,n = 150,平均差异 = -392欧元,95%CI [-1.254,-26],这主要是由于支持性护理成本较低,平均差异 = 252欧元,95%CI [-1.009,42]。就所有结果而言,在每改善0欧元的支付意愿阈值下,痴呆症患者使用FindMyApps具有成本效益的概率为0.72,护理人员使用FindMyApps具有成本效益的概率为0.93:结论:FindMyApps 是一项具有成本效益的干预措施,可增强护理人员的能力感。结论:FindMyApps 是一种支持照顾者能力感的经济有效的干预措施,有必要进一步推广 FindMyApps。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-effectiveness of the FindMyApps eHealth intervention vs. digital care as usual: results from a randomised controlled trial.

Objectives: Despite growing interest, the cost-effectiveness of eHealth interventions for supporting quality of life of people with dementia and their caregivers remains unclear. This study evaluated the cost-effectiveness of the FindMyApps intervention, compared to digital care-as-usual. FindMyApps aims to help people with dementia and their caregivers find and learn to use tablet apps that may support social participation and self-management of people with dementia and sense of competence of caregivers.

Method: A randomised controlled trial (Netherlands Trial Register NL8157) was conducted, including people with mild cognitive impairment (MCI) or mild dementia and their informal caregivers (FindMyApps n = 76, digital care-as-usual n = 74). Outcomes for people with MCI/dementia were Quality-Adjusted Life-Years (QALYs), calculated from EQ-5D-5L data and the Dutch tariff for utility scores, social participation (Maastricht Social Participation Profile) and quality of life (Adult Social Care Outcomes Toolkit), and for caregivers, QALYs and sense of competence (Short Sense of Competence Questionnaire). Societal costs were calculated using data collected with the RUD-lite instrument and the Dutch costing guideline. Multiple imputation was employed to fill in missing cost and effect data. Bootstrapped multilevel models were used to estimate incremental total societal costs and incremental effects between groups which were then used to calculate Incremental Cost-Effectiveness Ratios (ICERs). Cost-effectiveness acceptability curves were estimated.

Results: In the FindMyApps group, caregiver SSCQ scores were significantly higher compared to care-as-usual, n = 150, mean difference = 0.75, 95% CI [0.14, 1.38]. Other outcomes did not significantly differ between groups. Total societal costs for people with dementia were not significantly different, n = 150, mean difference = €-774, 95%CI [-2.643, .,079]. Total societal costs for caregivers were significantly lower in the FindMyApps group compared to care-as-usual, n = 150, mean difference = € -392, 95% CI [-1.254, -26], largely due to lower supportive care costs, mean difference = €-252, 95% CI [-1.009, 42]. For all outcomes, the probability that FindMyApps was cost-effective at a willingness-to-pay threshold of €0 per point of improvement was 0.72 for people with dementia and 0.93 for caregivers.

Conclusion: FindMyApps is a cost-effective intervention for supporting caregivers' sense of competence. Further implementation of FindMyApps is warranted.

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来源期刊
Aging & Mental Health
Aging & Mental Health 医学-精神病学
CiteScore
7.00
自引率
2.90%
发文量
176
审稿时长
4-8 weeks
期刊介绍: Aging & Mental Health provides a leading international forum for the rapidly expanding field which investigates the relationship between the aging process and mental health. The journal addresses the mental changes associated with normal and abnormal or pathological aging, as well as the psychological and psychiatric problems of the aging population. The journal also has a strong commitment to interdisciplinary and innovative approaches that explore new topics and methods. Aging & Mental Health covers the biological, psychological and social aspects of aging as they relate to mental health. In particular it encourages an integrated approach for examining various biopsychosocial processes and etiological factors associated with psychological changes in the elderly. It also emphasizes the various strategies, therapies and services which may be directed at improving the mental health of the elderly and their families. In this way the journal promotes a strong alliance among the theoretical, experimental and applied sciences across a range of issues affecting mental health and aging. The emphasis of the journal is on rigorous quantitative, and qualitative, research and, high quality innovative studies on emerging topics.
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