Cost-utility analysis of community occupational therapy in dementia (COTiD-UK) versus usual care: Results from VALID, a multi-site randomised controlled trial in the UK.
View / Open Files
Authors
Mundy, Jacqueline
Orrell, Martin
King, Michael
Omar, Rumana
Morris, Stephen
Publication Date
2022Journal Title
PLoS One
ISSN
1932-6203
Publisher
Public Library of Science (PLoS)
Volume
17
Issue
2
Language
eng
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Pizzo, E., Wenborn, J., Burgess, J., Mundy, J., Orrell, M., King, M., Omar, R., & et al. (2022). Cost-utility analysis of community occupational therapy in dementia (COTiD-UK) versus usual care: Results from VALID, a multi-site randomised controlled trial in the UK.. PLoS One, 17 (2) https://doi.org/10.1371/journal.pone.0262828
Abstract
BACKGROUND: A community-based occupational therapy intervention for people with mild to moderate dementia and their family carers: the Community Occupational Therapy in Dementia-UK version (COTiD-UK); and Treatment as usual (TAU) were randomly assigned to 468 pairs (each comprising a person with dementia and a family carer) in the Valuing Active Life in Dementia (VALID) randomised controlled trial (RCT). OBJECTIVES: To compare the cost-utility of the COTiD-UK intervention compared to TAU, using data from the VALID RCT. METHODS: We performed a cost-utility analysis estimating mean costs and quality adjusted life years (QALYs) per person with dementia and carer for both treatments over a 26 weeks' time horizon based on resource use data and utility values collected in the trial. RESULTS: Taking the National Health Service and Personal Social Services perspective, including costs and benefits to the person with dementia only, measuring Health Related Quality of Life based on Dementia Quality of Life scale (DEMQOL), accounting for missing data and adjusting for baseline values, there was a significant difference in costs between COTiD-UK and TAU (mean incremental cost for COTiD-UK £784 (95% CI £233 to £1334)), but no significant difference in outcomes (mean QALYs gained 0.00664 (95% CI -0.00404, 0.01732)). The Incremental Net Monetary Benefit (INMB) for COTiD-UK versus TAU was negative at a maximum willingness to pay for a QALY of £20000 (mean -£651, 95% CI -£878 to -£424) or £30000 (mean -£585, 95% CI -£824 to -£345). Extensive sensitivity analyses confirmed the results. CONCLUSIONS: This community-based occupational therapy intervention has a very low probability of being cost-effective.
Keywords
Humans, Dementia, Treatment Outcome, Occupational Therapy, Quality-Adjusted Life Years, Caregivers, Cost-Benefit Analysis, United Kingdom
Sponsorship
National Institute for Health Research (NIHR) (RP-PG-0610-10108)
Identifiers
PMC8836304, 35148329
External DOI: https://doi.org/10.1371/journal.pone.0262828
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334988
Statistics
Total file downloads (since January 2020). For more information on metrics see the
IRUS guide.
Recommended or similar items
The current recommendation prototype on the Apollo Repository will be turned off on 03 February 2023. Although the pilot has been fruitful for both parties, the service provider IKVA is focusing on horizon scanning products and so the recommender service can no longer be supported. We recognise the importance of recommender services in supporting research discovery and are evaluating offerings from other service providers. If you would like to offer feedback on this decision please contact us on: support@repository.cam.ac.uk