Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study

Objective – to assess the cost effectiveness of community based occupational therapy compared with usual care in older patients with dementia and their care givers from a societal viewpoint. Design – cost effectiveness study alongside a single blind randomised controlled trial. Setting – memory clinic, day clinic of a geriatrics department and participants' homes. Patients – 135 patients aged ≥65 with mild to moderate dementia living in the community and their primary care givers. Intervention – 10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision. Main outcome measures – incremental cost effectiveness ratio expressed as the difference in mean total care costs per successful treatment (that is, a combined patient and care giver outcome measure of clinically relevant improvement on process, performance, and competence scales) at three months after randomisation. Bootstrap methods used to determine confidence intervals for these measures.