title: Maintenance cognitive stimulation therapy: an economic evaluation within a randomized controlled trial.
abstract: BACKGROUND
  Cognitive Stimulation Therapy (CST) is effective and cost-effective for people with mild-to-moderate dementia when delivered biweekly over 7 weeks.
  
  
  OBJECTIVE
  To examine whether longer-term (maintenance) CST is cost-effective when added to usual care.
  
  
  METHODS
  Cost-effectiveness analysis within multicenter, single-blind, pragmatic randomized controlled trial; subgroup analysis for people taking acetylcholinesterase inhibitors (ACHEIs). A total of 236 participants with mild-to-moderate dementia received CST for 7 weeks. They were randomized to either weekly maintenance CST added to usual care or usual care alone for 24 weeks.
  
  
  RESULTS
  Although outcome gains were modest over 6 months, maintenance CST appeared cost-effective when looking at self-rated quality of life as primary outcome, and cognition (MMSE) and proxy-rated quality-adjusted life years as secondary outcomes. CST in combination with ACHEIs offered cost-effectiveness gains when outcome was measured as cognition.
  
  
  CONCLUSIONS
  Continuation of CST is likely to be cost-effective for people with mild-to-moderate dementia.
authors.affiliation: Personal Social Services Research Unit, London School of Economics and Political Science, London, UK. Electronic address: damico@lse.ac.uk.
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Amico
authors.affiliation: Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
authors.forename: Amritpal
authors.initials: A
authors.lastname: Rehill
authors.affiliation: Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.affiliation: Dementia Care Research Centre, Research and Development Department, Maggie Lilley Suite, Goodmayes Hospital, North East London NHS Foundation Trust, Ilford, Essex, UK.
authors.forename: Elisa
authors.initials: E
authors.lastname: Aguirre
authors.affiliation: Clinical Psychology Service, South Essex Partnership NHS Foundation Trust, Healthlink, Bedford, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Donovan
authors.affiliation: North Wales Organisation for Randomised Trials in Health (NWORTH), Institute of Medical and Social Care Research, Bangor, Wales.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Hoare
authors.affiliation: Division of Psychiatry, University College London, London, UK.
authors.forename: Juanita
authors.initials: J
authors.lastname: Hoe
authors.affiliation: College of Medicine, Swansea University, Swansea, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Russell
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
authors.forename: Aimee
authors.initials: A
authors.lastname: Spector
authors.affiliation: Dementia Care Research Centre, Research and Development Department, Maggie Lilley Suite, Goodmayes Hospital, North East London NHS Foundation Trust, Ilford, Essex, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Streater
authors.affiliation: North Wales Organisation for Randomised Trials in Health (NWORTH), Institute of Medical and Social Care Research, Bangor, Wales.
authors.forename: Christopher
authors.initials: C
authors.lastname: Whitaker
authors.affiliation: DSDC Wales, Bangor University, Bangor, Gwynedd, Wales.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Woods
authors.affiliation: Division of Psychiatry, University College London, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Orrell
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000191:economics* / Q000379:methods*; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000188:drug therapy / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors
keywords: Cognitive stimulation therapy; acetylcholinesterase inhibitors; cost; cost-effectiveness; dementia; randomized controlled trial