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Economic evaluation of a software application (Support, Monitoring and Reminder Technology for Mild Dementia [SMART4MD]) designed for older adults with mild cognitive impairment (MCI)
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
Lunds universitet.
Lunds universitet.
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0003-4312-2246
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: A randomized controlled trial of the SMART4MD tablet application was conducted for persons with mild cognitive impairment (PwMCI) and their informal caregivers to improve or maintain quality of life.

Objective: The objective was to conduct economic evaluation of SMART4MD compared to standard care in Sweden from a healthcare provider perspective based on a 6-month follow-up period.

Methods: Three hundred forty-five dyads were enrolled: 173 dyads in the intervention group and 172 in standard care. The primary outcome measures for PwMCI and informal caregivers were quality-adjusted life years (QALY). The results arepresented as incremental cost-effectiveness ratios, and confidence intervals are calculated using non-parametric bootstrap procedure.

Results: For PwMCI, the mean difference in total costs between intervention and standard care was D 12 (95%CI: –2090to 2115) (US$ = D 1.19) and the mean QALY change was –0.004 (95%CI: –0.009 to 0.002). For informal caregivers, the cost difference was – D 539 (95%CI: –2624 to 1545) and 0.003 (95%CI: –0.002 to 0.008) for QALY. The difference in cost and QALY for PwMCI and informal caregivers combined was –D 527 (95%CI: –3621 to 2568) and –0.001 (95%CI: –0.008to 0.006). Although generally insignificant differences, this indicates that SMART4MD, compared to standard care was: 1) more costly and less effective for PwMCI, 2) less costly and more effective for informal caregivers, and 3) less costly and less effective for PwMCI and informal caregivers combined.

Keywords [en]
Carer, cost-effectiveness, economic evaluation, elderly, memory, mHealth, mild cognitive impairment, mild dementia, mobile application, smartphone
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Applied Health Technology
Identifiers
URN: urn:nbn:se:bth-20586OAI: oai:DiVA.org:bth-20586DiVA, id: diva2:1484350
Funder
EU, Horizon 2020, 643399
Note

A revised version was published in 2022 with the title "Short Term Economic Evaluation of the Digital Platform 'Support, Monitoring and Reminder Technology for Mild Dementia' (SMART4MD) for People with Mild Cognitive Impairment and their Informal Caregivers":

DOI: 10.3233/JAD-215013

Available from: 2020-10-28 Created: 2020-10-28 Last updated: 2025-09-30Bibliographically approved
In thesis
1. Cost-effectiveness analysis of an mHealth application (SMART4MD) and analysis of the effect of dialysis treatments on labor market outcomes: Health technology assessment of two treatment methods
Open this publication in new window or tab >>Cost-effectiveness analysis of an mHealth application (SMART4MD) and analysis of the effect of dialysis treatments on labor market outcomes: Health technology assessment of two treatment methods
2020 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Health Technology Assessment is an important factor for decision making in the healthcare sector in Sweden. It helps to curtail the rising costs associated with the healthcare sector and aids in the efficient allocation of scarce public health resources. This thesis investigates the cost-effectiveness and the effectiveness in general of two health technologies, addressing the following research objectives: i) assessing the cost-effectiveness of mobile health (mHealth) interventions designed for older adults diagnosed with mild cognitive impairment, and ii) assessing the effectiveness of peritoneal dialysis (PD) treatment on labor market outcomes in comparison with institutional hemodialysis (IHD) treatment in Swedish settings.

Study I and Study II are related to the first research objective. In Study I, we summarized and critically assessed the current evidence on the cost-effectiveness of mHealth interventions focusing on older adults; we found some evidence supporting the cost-effectiveness of these interventions. In Study II, we conducted a within-trial cost-effectiveness analysis of the software application Support, Monitoring and Reminder Technology for Mild Dementia (SMART4MD) from a healthcare perspective for a period of six months. A total of 345 Swedish dyads (MCI patient and informal caregiver) participated in this study. For a short time period of six months, we found that SMART4MD is not cost-effective for MCI patients (statistically insignificant); however, a trend was observed that indicated that it might be cost-effective for informal caregivers, although results remained statistically insignificant (p > 0.05).

Study III is related to the second research objective. In Study III, we investigated the effect of PD on labor market outcomes (employment rate, work income, and disability pension) in comparison to IHD. We found that PD is associated with a treatment advantage over IHD in terms of increased employment, work income, and reduced disability pension in the Swedish population after controlling for non-random selection for the treatment.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2020. p. 35 (kappa)
Series
Blekinge Institute of Technology Licentiate Dissertation Series, ISSN 1650-2140 ; 7
Keywords
Aged, Cost-benefit analysis, Gerontechnology, Telemedicine, Elderly, Mobile application, mHealth, Mobile health
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:bth-20587 (URN)978-91-7295-412-0 (ISBN)
Available from: 2020-10-29 Created: 2020-10-28 Last updated: 2025-09-30Bibliographically approved

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Ghani, ZartashiaSanmartin Berglund, JohanAndersson, MartinAnderberg, Peter

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