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Costs of Care of Agitation Associated With Dementia in 8 European Countries : Results From the RightTimePlaceCare Study

Costa, Nadège; Wübker, Ansgar; De Mauléon, Adelaïde; Zwakhalen, Sandra M.G.; Challis, David; Leino-Kilpi, Helena; Stephan, Astrid; Zabalegui, Adelaida; Saks, Kai and Molinier, Laurent, et al. (2018) In Journal of the American Medical Directors Association 19(1). p.1-95
Abstract

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... (More)

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.

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published
subject
keywords
agitation, costs, Dementia, Europe, informal care, long-term care
in
Journal of the American Medical Directors Association
volume
19
issue
1
pages
1 - 95
publisher
Elsevier
external identifiers
  • scopus:85039935155
ISSN
1525-8610
DOI
10.1016/j.jamda.2017.10.013
language
English
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no
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a82b5a3b-d0b6-426a-9796-faffe4ac3bfe
date added to LUP
2018-01-22 12:19:13
date last changed
2018-05-29 09:45:57
@article{a82b5a3b-d0b6-426a-9796-faffe4ac3bfe,
  abstract     = {<p>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 &lt;.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.</p>},
  author       = {Costa, Nadège and Wübker, Ansgar and De Mauléon, Adelaïde and Zwakhalen, Sandra M.G. and Challis, David and Leino-Kilpi, Helena and Stephan, Astrid and Zabalegui, Adelaida and Saks, Kai and Molinier, Laurent and Wimo, Anders and Vellas, Bruno and Sauerland, Dirk and Binot, Ingrid and Soto, Maria E. and , },
  issn         = {1525-8610},
  keyword      = {agitation,costs,Dementia,Europe,informal care,long-term care},
  language     = {eng},
  number       = {1},
  pages        = {1--95},
  publisher    = {Elsevier},
  series       = {Journal of the American Medical Directors Association},
  title        = {Costs of Care of Agitation Associated With Dementia in 8 European Countries : Results From the RightTimePlaceCare Study},
  url          = {http://dx.doi.org/10.1016/j.jamda.2017.10.013},
  volume       = {19},
  year         = {2018},
}