Background Almost 44 million people are currently living with dementia worldwide. This number is set to increase threefold by 2050, posing a serious threat to the sustainability of healthcare systems. Overuse of antipsychotic drugs for the management of the symptoms of dementia carries negative consequences for patients while also increasing the health expenditures for society. Supportive care (SC) interventions could be considered a safer and potentially cost-saving option. In this paper we provide a systematic review of the existing evidence regarding the cost-effectiveness and cost-utility of SC interventions targeted towards persons living with dementia and their caregivers. Methods A systematic literature review was performed between February 2019 and December 2021 through searches of the databases PubMed (MEDLINE), Cochrane Library, CENTRAL, Embase and PsycINFO. The search strategy was based on PRISMA 2020 recommendations. We considered studies published through December 2021 with no lower date limit. We distinguished between five categories of SC strategies: cognitive therapies, physical activity, indirect strategies (organisational and environmental changes), interventions primarily targeted towards family caregivers, and multicomponent interventions. Results Of the 5,479 articles retrieved, 39 met the inclusion criteria. These studies analysed 35 SC programmes located at different stages of the dementia care pathway. Eleven studies provided evidence of high cost-effectiveness for seven interventions: two multicomponent interventions; two indirect interventions; two interventions aimed at caregivers of community-dwelling persons with dementia; one community-based cognitive stimulation and occupational programme. Conclusion We find that the most promising SC strategies in terms of cost-effectiveness are multicomponent interventions (targeted towards both nursing home residents and day-care service users), indirect strategies (group living and dementia care management at home), some forms of tailored occupational therapy, together with some psychosocial interventions for caregivers of community-dwelling persons with dementia. Our results suggest that the adoption of effective SC interventions may increase the economic sustainability of dementia care.
T he pu rpos e of t his pa pe r is t o p ro pos e a m e t hod olog ic al f ram e w ork f or t he e v alu at ion/as s es s m e nt of t he we b im ag e and re pu t at ion of a de s t inat ion as a s e lf -analy s is proc e s s le ading t ow ards t he bu ilding of a c om pe t it iv e de s t inat ion brand. T his proc e s s is e v e n m ore im port ant f or t ou ris m de s t inat ions /produ c t s , su c h as t he It alian c oas t al de s t inat ions labe lle d G 2 0 S, w hos e pu rpos e is t o im prov e t he ir c om pe t it iv e ne s s in t he t ou rist m ark e t t hrou g h a re nov at e d im ag e . T he st u dy pres e nt s an im ag e of t he It alian c oas t al de s t inat ions t hrou g h de s t inat ions rank i ng inde xe s and hig hlig ht ing t he ir at t ri bu t e s ; t his c an be a u s e f u l ins t ru m e nt f or all de s t inat ion m anag e rs and de c is ion m ak e rs t o m onit or t he ir de s t inat ion' s onli ne re pu t at ion and s u pport t he brand -bu ildi ng /bra nd m anag e m e nt proc e s s . More ov e r, t he w e b re pu t at ion and t he w e b im ag e ana ly s is of a de s t inat ion allow s t o de v e lop an e f f e c t iv e c o -c re at ion pr oc e s s and adopt m ark e t ing ac t ions in line w it h ne w t re nds f rom t he d e m and s ide .
The purpose of this paper is to propose a methodology for the assessment of a destination's image on the web. The study builds up a picture of 26 Italian coastal destinations through indexes and highlighting the reputation of the tourism services (attractions, restaurants, and accommodation). This can be a useful tool for destination managers to help monitor their destination's online reputation and support the brand-building and management through a co-creation.
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