MODEM: A comprehensive approach to modelling outcome and costs impacts of interventions for dementia. Protocol paper

Abstract

BackgroundThe MODEM project (A comprehensive approach to MODelling outcome and costs impacts of interventions for DEMentia) explores how changes in arrangements for the future treatment and care of people living with dementia, and support for family and other unpaid carers, could result in better outcomes and more efficient use of resources.MethodsMODEM starts with a systematic mapping of the literature on effective and (potentially) cost-effective interventions in dementia care. Those findings, as well as data from a cohort, will then be used to model the quality of life and cost impacts of making these evidence-based interventions more widely available in England over the period from now to 2040. Modelling will use a suite of models, combining microsimulation and macrosimulation methods, modelling the costs and outcomes of care, both for an individual over the life-course from the point of dementia diagnosis, and for individuals and England as a whole in a particular year.Project outputs will include an online Dementia Evidence Toolkit, making evidence summaries and a literature database available free to anyone, papers in academic journals and other written outputs, and a MODEM Legacy Model, which will enable local commissioners of services to apply the model to their own populations.DiscussionModelling the effects of evidence-based cost-effective interventions and making this information widely available has the potential to improve the health and quality of life both of people with dementia and their carers, while ensuring that resources are used efficiently.

DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers (DETERMIND): A protocol paper

“…15 Participants will then be contacted annually (for three years) to arrange follow-up visits. The person with dementia and their carer (if applicable) will both complete the assessment.…”

“…Stage 1 (months 1 to 24): We will complete secondary analyses of data from the MODEM study, 15 the English Longitudinal Survey of Ageing (ELSA), 16 …”

“…Such a strategy has worked well in the MODEM study. 15 Participants will then be contacted annually (for three years) to arrange follow-up visits. The assessments will include quantitative questionnaires to assess patient quality of life, cognitive function, patient neuropsychiatric symptoms, carer quality of life, carer burden, use of services, 7patient activities of daily living, medication, and physical illnesses (see Table 1 for an overview of all baseline measures).…”

“…Stage 1 (months 1 to 24): We will complete secondary analyses of data from the MODEM study, 15 the English Longitudinal Survey of Ageing (ELSA), 16 identify, for those at earlier stages of cognitive decline, the level of and change in unmet needs and their socioeconomic correlates, and how these affect access to care and outcomes such as probability of entering a care home and quality of life. CFAS will allow us to explore a limited number of service use and demographic variables in an epidemiologically generalisable group of well characterised people with dementia.…”

Challenges and recommendations for the health-economic evaluation of primary prevention programmes for dementia

“…cardiovascular and cerebrovascular disorders), also referred to as 'unintended benefits'. Lin et al (2014) estimated these costs using a dynamic aging process model (Yang, Zhang, Lin, Clevenger, & Atherly, 2012), and this issue will be addressed by a model currently under development (Comas-Herrera et al, 2017). As an alternative to the dynamic aging model, a Markov structure could make the costs in the 'no dementia' state depend on the modifiable risk factors, to reflect the health-economic effect of reducing the incidence of other diseases.…”