Abstract
Objectives
To examine the within-trial costs and cost-effectiveness of using PARO, compared with
a plush toy and usual care, for reducing agitation and medication use in people with
dementia in long-term care.
Design
An economic evaluation, nested within a cluster–randomized controlled trial.
Setting
Twenty-eight facilities in South-East Queensland, Australia.
Participants
A total of 415 residents, all aged 60 years or older, with documented diagnoses of
dementia.
Intervention
Facilities were randomized to 1 of 3 groups: PARO (individual, nonfacilitated 15-minute
sessions, 3 afternoons per week for 10 weeks); plush toy (as per PARO but with artificial
intelligence disabled); and usual care.
Measurements
The incremental cost per Cohen-Mansfield Agitation Inventory–Short Form (CMAI-SF)
point averted from a provider's perspective. Australian New Zealand Clinical Trials
Registry (BLINDED FOR REVIEW).
Results
For the within-trial costs, the PARO group was $50.47 more expensive per resident
compared with usual care, whereas the plush toy group was $37.26 more expensive than
usual care. There were no statistically significant between-group differences in agitation
levels after the 10-week intervention. The point estimates of the incremental cost-effectiveness
ratios were $13.01 for PARO and $12.85 for plush toy per CMAI-SF point averted relative
to usual care.
Conclusion
The plush toy used in this study offered marginally greater value for money than PARO
in improving agitation. However, these costs are much lower than values estimated
for psychosocial group activities and sensory interventions, suggesting that both
a plush toy and the PARO are cost-effective psychosocial treatment options for agitation.
Keywords
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Article info
Publication history
Published online: January 09, 2018
Footnotes
Conflicts of interest: Dr. Takanori Shibata, the developer of PARO, provided five additional PAROs for the study. He had no role in any aspect of the study design, undertaking, analysis, and interpretation, or in the reporting of findings and manuscript preparation. The authors declare no other financial, personal, or potential conflicts of interest.
Funding: This work was supported by the Australian National Health and Medical Research Council (APP1065320).
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
