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Support, Monitoring, and Reminder Technology for Mild Dementia (SMART4MD) for People With Mild Cognitive Impairment and Their Informal Caregivers: Cost-Effectiveness Analysis

Ghani, Zartashia LU ; Jarl, Johan LU orcid ; Anderberg, Peter ; Sanmartin Berglund, Johan ; Quintana Aparicio, Maria ; Barnestein-Fonseca, Pilar ; Cellek, Selim ; Mayoral-Cleries, Fermín ; Garolera, Maite and Guerrero-Pertiñez, Gloria , et al. (2026) In JMIR Human Factors 13. p.1-17
Abstract
Background:
Support, Monitoring, and Reminder Technology for Mild Dementia (SMART4MD), a customized tablet app, was developed to improve or maintain the quality of life of people with mild cognitive impairment (MCI) and their informal caregivers.

Objective:
This study conducts an 18-month economic evaluation of the SMART4MD app, in addition to standard care, compared with standard care alone in Sweden and Spain, from a health care provider perspective.

Methods:
In a pragmatic randomized controlled trial, people with MCI and their informal caregivers were randomized to the intervention and control groups. Health care costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs)... (More)
Background:
Support, Monitoring, and Reminder Technology for Mild Dementia (SMART4MD), a customized tablet app, was developed to improve or maintain the quality of life of people with mild cognitive impairment (MCI) and their informal caregivers.

Objective:
This study conducts an 18-month economic evaluation of the SMART4MD app, in addition to standard care, compared with standard care alone in Sweden and Spain, from a health care provider perspective.

Methods:
In a pragmatic randomized controlled trial, people with MCI and their informal caregivers were randomized to the intervention and control groups. Health care costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were measured in 345 Swedish people with MCI and their informal caregivers, and in 347 Spanish people with MCI.

Results:
The analysis showed higher incremental costs and lower QALYs for Swedish people with MCI than for controls, whereas higher incremental costs and higher QALYs were observed for Spanish people with MCI. The intervention was not found to be cost-effective for Swedish informal caregivers, with an ICER of €78,000/QALY (€1=US $1.16).

Conclusions:
The differing findings regarding cost-effectiveness for people with MCI in Sweden and Spain highlight the need for further research with extended follow-up, ideally involving a larger sample size and conducted across different national contexts. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
JMIR Human Factors
volume
13
article number
e77808
pages
1 - 17
publisher
JMIR Publications Inc.
external identifiers
  • pmid:42172614
ISSN
2292-9495
DOI
10.2196/77808
language
English
LU publication?
yes
id
05fb0bd8-2b4b-464b-90c5-405e89bba58c
date added to LUP
2026-05-22 21:15:16
date last changed
2026-05-25 09:08:13
@article{05fb0bd8-2b4b-464b-90c5-405e89bba58c,
  abstract     = {{Background:<br/>Support, Monitoring, and Reminder Technology for Mild Dementia (SMART4MD), a customized tablet app, was developed to improve or maintain the quality of life of people with mild cognitive impairment (MCI) and their informal caregivers.<br/><br/>Objective:<br/>This study conducts an 18-month economic evaluation of the SMART4MD app, in addition to standard care, compared with standard care alone in Sweden and Spain, from a health care provider perspective.<br/><br/>Methods:<br/>In a pragmatic randomized controlled trial, people with MCI and their informal caregivers were randomized to the intervention and control groups. Health care costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were measured in 345 Swedish people with MCI and their informal caregivers, and in 347 Spanish people with MCI.<br/><br/>Results:<br/>The analysis showed higher incremental costs and lower QALYs for Swedish people with MCI than for controls, whereas higher incremental costs and higher QALYs were observed for Spanish people with MCI. The intervention was not found to be cost-effective for Swedish informal caregivers, with an ICER of €78,000/QALY (€1=US $1.16).<br/><br/>Conclusions:<br/>The differing findings regarding cost-effectiveness for people with MCI in Sweden and Spain highlight the need for further research with extended follow-up, ideally involving a larger sample size and conducted across different national contexts.}},
  author       = {{Ghani, Zartashia and Jarl, Johan and Anderberg, Peter and Sanmartin Berglund, Johan and Quintana Aparicio, Maria and Barnestein-Fonseca, Pilar and Cellek, Selim and Mayoral-Cleries, Fermín and Garolera, Maite and Guerrero-Pertiñez, Gloria and Hayden, Karen and Moore, Carmel Maria and Zhang, Jufen and Trepel, Dominic and Saha, Sanjib}},
  issn         = {{2292-9495}},
  language     = {{eng}},
  month        = {{05}},
  pages        = {{1--17}},
  publisher    = {{JMIR Publications Inc.}},
  series       = {{JMIR Human Factors}},
  title        = {{Support, Monitoring, and Reminder Technology for Mild Dementia (SMART4MD) for People With Mild Cognitive Impairment and Their Informal Caregivers: Cost-Effectiveness Analysis}},
  url          = {{http://dx.doi.org/10.2196/77808}},
  doi          = {{10.2196/77808}},
  volume       = {{13}},
  year         = {{2026}},
}