Cost-effectiveness of the Namaste care family program for nursing home residents with advanced dementia in comparison with usual care: a cluster-randomized controlled trial

Abstract

Background: Dementia is a progressive disease that decreases quality of life of persons with dementia and is associated with high societal costs. The burden of caring for persons with dementia also decreases the quality of life of family caregivers. The objective of this study was to assess the societal cost-effectiveness of Namaste Care Family program in comparison with usual care in nursing home residents with advanced dementia. Methods: Nursing homes were randomized to either Namaste Care Family program or usual care. Outcome measures of the cluster-randomized trial in 231 residents included Quality of Life in Late-Stage Dementia (QUALID) and the Gain in Alzheimer Care Instrument (GAIN) for family caregivers over 12 months of follow-up. Health states were measured using the EQ-5D-3L questionnaire which were translated into utilities. QALYs were calculated by multiplying the amount of time a participant spent in a specific health state with the utility score associated with that health state. Healthcare utilization costs were estimated using standard unit costs, while intervention costs were estimated using a bottom-up approach. Missing cost and effect data were imputed using multiple imputation. Bootstrapped multilevel models were used after multiple imputation. Cost-effectiveness acceptability curves were estimated.

Cost-effectiveness and return-on-investment of C-reactive protein point-of-care testing in comparison with usual care to reduce antibiotic prescribing for lower respiratory tract infections in nursing homes: a cluster randomised trial

“…Thus, we only included healthcare costs, which is different from a societal perspective in which all relevant costs are included regardless of who bears them. Consequently, we were not able to identify potential cost shifts between sectors, for instance from the healthcare system to the patient 48. However, considering that patients were nursing home residents and do not work anymore, we expect that societal costs related to the patient are limited (eg, informal care and productivity losses).…”

“…Consequently, we were not able to identify potential cost shifts between sectors, for instance from the healthcare system to the patient. 48 However, considering that patients were nursing home residents and do not work anymore, we expect that societal costs related to the patient are limited (eg, informal care and productivity losses). Also, the current study aims to inform decisions regarding implementation at the nursing home level, within context of the Dutch Long-Term Care Act which decentralises certain budget decisions to this setting.…”

Intervenciones de enfermería en salud familiar en familias con ancianos con Alzheimer: revisión integrativa

“…Las intervenciones enfocadas en el cuidador familiar con enfoque de enfermería familiar, permite abordar al cuidador familiar en su relación con el anciano con Alzheimer, teniendo buenos resultados; en la investigación realizada por Ha, Kwa, Won y Jung 19 en la historia de vida en donde utilizaron fotografías para recordar todo lo que han vivido como pareja permite fortalecer los vínculos permitiendo que la calidad conyugal se mantuviera pese a la enfermedad. Por su parte en la intervención de Namaste Care Family que fomenta la salud mental en los cuidadores principales, demostrando que la ganancia de cuidado se modificó luego de la intervención 20 .…”

Evaluating the feasibility, experiences, facilitators of and barriers to carers and volunteers delivering Namaste Care to people with dementia in their own home: a qualitative interview study in the UK and the Netherlands

“…There is an increasing body of research into the positive effects of Namaste Care on nursing home residents with dementia, nursing staff, and family carers, [13][14][15][16] its costs, [16][17][18] and the mechanisms of the programme. [19][20][21] Initial realist explanatory theories investigating if, how and under which circumstances Namaste Care works in the home setting suggest that the programme may also have positive effects on people with dementia and their carers living in the community.…”