TY - JOUR
T1 - Cost-effectiveness of exergaming compared to regular day-care activities in dementia
T2 - Results of a randomised controlled trial in The Netherlands
AU - van Santen, Joeke
AU - Meiland, Franka J. M.
AU - Dröes, Rose-Marie
AU - van Straten, Annemieke
AU - Bosmans, Judith E.
N1 - Funding Information: The research project received funding from ZonMw-Memorabel programme/Alzheimer Nederland (project number 733050609), Stichting Dioraphte (project number 16 02 04 03) and the EU. This trial was carried out as part of the Marie Skłodowska Curie funded INDUCT Innovative Training Network (ITN) (Interdisciplinary Network for Dementia Using Current Technology (INDUCT)), H2020-MSCA-ITN-2015, under grant agreement number 676265. Additional funding was received from Association of Support VCVGZ. We would like to thank Olivier Blanson Henkemans (TNO), Sjef van Bommel (Sjef van Bommel Management & Support), Esther Hakvoort (Evean), Marije Holstege (GRZ Plus), Carla Scholten (Embedded Fitness), Marian Schoone (TNO), Marjolein Smit (SilverFit), Ronald Valk (HilverZorg), and Joris Wiersinga (SilverFit) for their contributions to the study as project group members. Additionally, we would like to thank all the persons with dementia, informal caregivers, staff of day-care centres and care organisations who participated, and all other people who contributed to the research study. Funding Information: The research project received funding from ZonMw‐Memorabel programme/Alzheimer Nederland (project number 733050609), Stichting Dioraphte (project number 16 02 04 03) and the EU. This trial was carried out as part of the Marie Skłodowska Curie funded INDUCT Innovative Training Network (ITN) (Interdisciplinary Network for Dementia Using Current Technology (INDUCT)), H2020‐MSCA‐ITN‐2015, under grant agreement number 676265. Additional funding was received from Association of Support VCVGZ. Publisher Copyright: © 2021 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.
PY - 2022/9
Y1 - 2022/9
N2 - The growing number of people living with dementia will result in increased costs of dementia worldwide. The e-Health intervention ‘Exergaming’ may improve health and quality of life of people with dementia, but the cost-effectiveness is unknown. We assessed the cost-effectiveness of exergaming compared to regular activities from a societal perspective in day-care centres (DCC) for people with dementia and their informal caregivers (IC) alongside a cluster randomised controlled trial. We included 112 dyads (person with dementia and IC) from 20 psychogeriatric DCCs (11 exergaming, 9 control) across the Netherlands. Exergaming consisted of interactive cycling at least twice a week for 6 months. Measurements were conducted at baseline (T0), after 3 (T1) and 6 (T2) months. Primary outcomes were minutes of physical activity, mobility of the participants with dementia (Short Physical Performances Battery, SPPB), and Quality-Adjusted Life-Years (QALYs) of participants with dementia and ICs. ICs filled out cost diaries to measure healthcare and informal care utilisation during the study. There were no statistically significant differences in outcomes or costs between the groups at the level of participants with dementia, the ICs or the dyad. With regard to QALYs and SPPB, the probability that exergaming is cost-effective compared to control was low for all possible willingness-to-pay (WTP) thresholds. However, for physical activity at WTP thresholds of 0, 50 and 250 Euros per additional minute of physical activity, the probability of cost-effectiveness is 0.46, 0.84 and 0.87, respectively. Exergaming in DCC was not cost-effective compared to usual activities. However, considering the small sample size and the large number of missing observations, findings should be interpreted with caution. Future studies with larger samples are recommended to obtain definitive answers on the cost-effectiveness of exergaming. This trial was registered in the Netherlands Trial Register (NTR5537/NL5420).
AB - The growing number of people living with dementia will result in increased costs of dementia worldwide. The e-Health intervention ‘Exergaming’ may improve health and quality of life of people with dementia, but the cost-effectiveness is unknown. We assessed the cost-effectiveness of exergaming compared to regular activities from a societal perspective in day-care centres (DCC) for people with dementia and their informal caregivers (IC) alongside a cluster randomised controlled trial. We included 112 dyads (person with dementia and IC) from 20 psychogeriatric DCCs (11 exergaming, 9 control) across the Netherlands. Exergaming consisted of interactive cycling at least twice a week for 6 months. Measurements were conducted at baseline (T0), after 3 (T1) and 6 (T2) months. Primary outcomes were minutes of physical activity, mobility of the participants with dementia (Short Physical Performances Battery, SPPB), and Quality-Adjusted Life-Years (QALYs) of participants with dementia and ICs. ICs filled out cost diaries to measure healthcare and informal care utilisation during the study. There were no statistically significant differences in outcomes or costs between the groups at the level of participants with dementia, the ICs or the dyad. With regard to QALYs and SPPB, the probability that exergaming is cost-effective compared to control was low for all possible willingness-to-pay (WTP) thresholds. However, for physical activity at WTP thresholds of 0, 50 and 250 Euros per additional minute of physical activity, the probability of cost-effectiveness is 0.46, 0.84 and 0.87, respectively. Exergaming in DCC was not cost-effective compared to usual activities. However, considering the small sample size and the large number of missing observations, findings should be interpreted with caution. Future studies with larger samples are recommended to obtain definitive answers on the cost-effectiveness of exergaming. This trial was registered in the Netherlands Trial Register (NTR5537/NL5420).
KW - costs and cost analysis
KW - dementia
KW - exercise
KW - healthcare costs
KW - physical fitness
KW - quality of life
KW - randomised controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85117140285&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/hsc.13608
DO - https://doi.org/10.1111/hsc.13608
M3 - Article
C2 - 34657346
SN - 0966-0410
VL - 30
SP - e1794-e1804
JO - Health and Social Care in the Community
JF - Health and Social Care in the Community
IS - 5
ER -