Costs and quality of life in community-dwelling patients with Alzheimer's disease in Spain: results from the GERAS II observational study

ABSTRACTBackground:Country-specific data on resource use and costs associated with Alzheimer's disease (AD) help inform governments about the increasing need for medical and financial support as the disease increases in prevalence.Methods:GERAS II, a prospective observational study, assessed resource use, costs, and health-related quality of life (HRQoL) among patients with AD and their caregivers in Spain. Community-dwelling patients aged ≥55 years with probable AD, and their primary caregivers, were recruited by study investigators during routine clinical practice and assessed as having mild, moderate, or moderately severe/severe (MS/S) AD dementia based on patient Mini-Mental State Examination scores. Costs of AD were calculated by applying costs to resource-use data obtained in caregiver interviews using the Resource Utilization in Dementia instrument. Total societal costs included patients’ health and social care costs and caregiver informal care costs. Baseline results are presented.Results:Total mean monthly societal costs/patient (2013 values) were €1514 for mild (n = 116), €2082 for moderate (n = 118), and €2818 for MS/S AD dementia (n = 146) (p value <0.001 between groups). Caregiver informal care costs comprised most of the total societal costs and differed significantly between groups (€1050, €1239, €1580, respectively; p value = 0.013), whereas patient healthcare costs did not. Across AD dementia severity groups, patient HRQoL (measured by proxy) decreased significantly (p value <0.001), caregiver subjective burden significantly increased (p value <0.001) and caregiver HRQoL was similar.Conclusions:Societal costs associated with AD in Spain were largely attributable to caregiver informal care costs and increased with increasing AD dementia severity.

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COSTS AND RESOURCE USE ASSOCIATED WITH ALZHEIMER’S DISEASE IN ITALY: RESULTS FROM AN OBSERVATIONAL STUDY

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2017.31 ◽

2017 ◽

pp. 1-10

Author(s):

G. Bruno ◽

M. Mancini ◽

G. Bruti ◽

G. Dell’Agnello ◽

C. Reed

Keyword(s):

Observational Study ◽

Informal Care ◽

Resource Use ◽

Mmse Score ◽

Dementia Patient ◽

Societal Costs ◽

Caregiver Time ◽

Dementia Severity ◽

Informal Care Costs ◽

Care Costs

Background: The GERAS II study aimed to assess societal costs and resource use associated with Alzheimer’s disease (AD) for patients and their primary caregivers in Italy and Spain, stratified for different severity stages of AD at baseline. This report presents baseline results for Italy. Design: GERAS II was a prospective, multicentre, observational study of routine care in AD. Setting: Community-dwelling patients attending specialist secondary care centres (memory clinics/Alzheimer’s Evaluation Units) and their primary informal caregivers were recruited into the study. Participants: Patients were aged ≥55 years, presented within the normal course of care, had a diagnosis of probable AD and a Mini-Mental State Examination (MMSE) score of ≤26. Patients and caregivers were stratified according to patient AD dementia severity at baseline: mild, MMSE score 21–26; moderate, MMSE score 15–20; or moderately severe/severe, MMSE score <15. Measurements: Data collected for patients and caregivers included demographics/clinical characteristics; current medication; patient cognitive, functional and behavioural assessments; patient and caregiver health-related quality of life (HRQoL); and patient and caregiver resource use. The costs associated with the resources used were calculated. Costs were broken down into patient healthcare costs, patient social care costs and caregiver informal care costs. Results: Of 198 patients enrolled from Italy, 29 (15%) had mild AD dementia, 80 (40%) had moderate AD dementia, and 89 (45%) had moderately severe/severe AD dementia. Patient and caregiver characteristics showed some differences between AD dementia severity groups; for example, a numerically higher proportion of patients with mild and moderately severe/severe AD dementia were taking memantine compared with those with moderate AD dementia. Patient functioning and behavioural and psychological symptoms worsened with increasing AD dementia severity (p<0.05 between groups for all measures). No significant difference between the disease severity groups was observed in patient HRQoL, and there was no clear pattern in resource use. However, all measures of caregiver time spent helping the patient differed significantly between groups (p<0.05) and were highest in patients with moderately severe/severe AD dementia. Mean (standard deviation) total monthly societal costs per patient (2013 values) were €1850 (1901), €1552 (1322) and €2728 (2184) for patients with mild, moderate and moderately severe/severe AD dementia, respectively (p<0.001 between groups). Caregiver informal care costs were the greatest contributor to total societal costs and amounted to €1370, €1223 and €2223 per patient per month for mild, moderate and moderately severe/severe AD dementia groups, respectively (p<0.001 between groups). Conclusion: Total Italian societal costs generally increased with increasing AD dementia severity. However, costs were slightly lower for moderate than for mild AD dementia, possibly reflecting the observed unusual trend of greater caregiver time and higher memantine use in patients with mild versus moderate AD dementia.

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Diabetes predicts decreased quality of life among community-dwelling seniors undertaking progressive resistance exercise: an observational study

Australian Journal of Physiotherapy ◽

10.1016/s0004-9514(09)70082-0 ◽

2009 ◽

Vol 55 (3) ◽

pp. 201-205 ◽

Cited By ~ 6

Author(s):

Kotaro Tamari

Keyword(s):

Quality Of Life ◽

Observational Study ◽

Resistance Exercise ◽

Community Dwelling ◽

Progressive Resistance Exercise ◽

Progressive Resistance

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Cost of informal care for community-dwelling mild–moderate dementia patients in a developed Southeast Asian country

International Psychogeriatrics ◽

10.1017/s1041610213000707 ◽

2013 ◽

Vol 25 (9) ◽

pp. 1475-1483 ◽

Cited By ~ 10

Author(s):

Mei Sian Chong ◽

Woan Shin Tan ◽

Mark Chan ◽

Wee Shiong Lim ◽

Noorhazlina Ali ◽

...

Keyword(s):

Resource Utilization ◽

Informal Care ◽

Asian Country ◽

Cost Of Care ◽

Community Dwelling ◽

Dementia Patients ◽

Moderate Dementia ◽

Domestic Help ◽

Informal Care Costs ◽

Care Costs

ABSTRACTBackground: Cost of informal care constitutes an important component of total dementia care cost. It also reflects resource utilization by patients and caregivers. We aim to quantify the informal cost of care for mild to moderate dementia patients.Methods: We recruited 165 patient–caregiver dyads with mild to moderate dementia. Informal care burden was assessed using the Resource Utilization in Dementia (RUD)-Lite instrument. A generalized linear model was fitted for association between cost of informal care and cognitive impairment, taking into account patient demographics, disease factors, and use of paid domestic help. Marginal estimates were obtained from the model for the purpose of illustration and discussion.Results: Total hours of informal care by primary caregiver doubled in moderate dementia patients, with 57.9% having paid domestic help to assist in care. Functional factors and use of paid domestic help were significantly associated with informal care costs. Costs were consistently higher for patients without paid domestic help for mild- and moderate dementia.Conclusion: This study demonstrates the informal care costs of caring for mild–moderate dementia patients in Singapore, with the unique cost savings provided by live-in paid domestic help, and potentially may aid policy-makers in allocation of resources and support to caregivers.

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Disease status, patient quality of life and healthcare resource use for ulcerative colitis in the UK: an observational study

Frontline Gastroenterology ◽

10.1136/flgastro-2013-100409 ◽

2014 ◽

Vol 5 (3) ◽

pp. 183-189 ◽

Cited By ~ 6

Author(s):

Carolynne J Vaizey ◽

Peter R Gibson ◽

Christopher M Black ◽

Rebecca J Nicholls ◽

Adèle R Weston ◽

...

Keyword(s):

Quality Of Life ◽

Ulcerative Colitis ◽

Observational Study ◽

Resource Use ◽

Healthcare Resource ◽

Disease Status ◽

Healthcare Resource Use ◽

The Uk

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PCV150 - HEALTH CARE RESOURCE USE AND QUALITY OF LIFE IN PATIENTS PRESCRIBED WITH SACUBITRIL/VALSARTAN IN PORTUGAL: A CROSS-SECTIONAL OBSERVATIONAL STUDY (PRIME STUDY)

Value in Health ◽

10.1016/j.jval.2018.09.695 ◽

2018 ◽

Vol 21 ◽

pp. S116-S117

Author(s):

M. Afonso-Silva ◽

P.A. Laires ◽

C. Gonçalves ◽

M. Cary ◽

J.P. Guerreiro ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Observational Study ◽

Resource Use ◽

Health Care Resource ◽

Cross Sectional ◽

Health Care Resource Use

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Quality of Life and Caregiver Burden of Alzheimer’s Disease Among Community Dwelling Patients in Europe: Variation by Disease Severity and Progression

Journal of Alzheimer s Disease Reports ◽

10.3233/adr-210025 ◽

2021 ◽

pp. 1-14

Author(s):

Lutz Froelich ◽

Albert Lladó ◽

Rezaul K. Khandker ◽

Montse Pedrós ◽

Christopher M. Black ◽

...

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Disease Progression ◽

Caregiver Burden ◽

Resource Use ◽

Independent Predictor ◽

Community Dwelling ◽

Over Time

Background: Alzheimer’s disease (AD) is a significant burden on patients and caregivers. How this burden increases as disease progresses has not been well researched. Objective: To assess the association of caregiver burden and quality of life with Alzheimer’s disease severity and disease progression in community-dwelling patients in Germany, Spain, and the UK. Methods: This was a prospective observational longitudinal study of mild-to-moderate AD patients (assessed by Mini-Mental State Examination, MMSE), and their caregivers. The humanistic burden was assessed using these instruments: [Rapid Assessment of Physical Activity (RAPA), EuroQoL-5-Dimension Level (EQ-5D-5L)] and caregiver-reported [Dependence Scale (DS), EQ-5D-5L, Zarit Burden Interview (ZBI)]. Caregiver-reported healthcare resource use was assessed using the Resource Use in Dementia (RUD) and ad-hoc questions. Results: Of 616 patients recruited, 338 and 99 were followed-up at 12 and 18 months, respectively. The caregiver-reported EQ-5D-5L scores of patients’ health-related quality of life (HRQoL) showed a negative trend over time (baseline: 0.76; 18 months: 0.67) while patient-reported HRQoL remained at 0.85. DS scores tended to worsen. Disease progression was an independent predictor of HRQoL and increased dependence. Mean ZBI score increased over time reflecting an increase in caregiver burden; MMSE being an independent predictor for caregiver burden. Patient resource utilization and caregiver time for caregiving tended to increase over time. Conclusion: We found significant association between disease progression and caregiver and patient burden. Independently, both disease-specific outcomes and disease burden measures increased over time, but as disease progresses, we also found incremental burden associated with it.

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Association Between Physical Activity and Osteoarthritis of Knee with Quality of Life in Community-Dwelling Older Adults

10.3233/shti210611 ◽

2021 ◽

Author(s):

Nachalida Yukalang ◽

Niruwan Turnbull ◽

Wisit Thongkum ◽

Adisorn Wongkongdech ◽

Kukiat Tudpor

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Older Adults ◽

Community Dwelling ◽

P Value ◽

Physically Active ◽

Osteoarthritis Of Knee ◽

Life Scale ◽

Community Dwelling Older Adults

Older adults are relatively physically active compared to other age group. A lack of physical activity (PA) can cause chronic diseases including osteoarthritis of knee (OA knee) and might eventually reduce quality of life (QOL). This present study was aimed to investigate association between levels of PA and OA knee with levels of QOL in community-dwelling older adults. One thousand and sixty-seven community-dwelling older persons were recruited to this descriptive study. PA activity questionnaire was invented. Standardized Oxford knee score and World Health Organization’s Quality of Life scale (WHOQOL-BREF) were used to measure OA knee and QOL levels. Results showed that levels of PA in older adults were significantly associated with levels of OKS (χ2 = 78.565, P-value < .001) and levels of OA knee in older adults were significantly associated with levels of overall QOL (χ2 = 57.738, P-value < .001). Pearson’s correlation also showed interrelation among PA, OA knee, and QOL. In conclusion, PA, OA knee, and QOL are interrelated. Therefore, close monitoring and design of proper PA activity should be implemented in community-dwelling older adults with OA knee.

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6082A prospective, multicenter, nationwide, observational study of flecainide controlled release on the quality of life of patients with atrial fibrillation in Greece, the REFLEC-CR study

European Heart Journal ◽

10.1093/eurheartj/ehz746.0126 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Tzeis ◽

D Tsiachris ◽

S P Kourouklis ◽

F Patsourakos ◽

D Karlis ◽

...

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Controlled Release ◽

Observational Study ◽

Oral Treatment ◽

Treatment Compliance ◽

P Value ◽

Minor Effect ◽

Nationwide Observational Study

Abstract Background/Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia with a considerable impact on patients' quality of life (QoL). Flecainide acetate, is a class Ic antiarrhythmic agent, recommended as first line treatment in AF patients without underlying structural heart disease. Purpose This prospective, multicenter, nationwide, observational study aimed to evaluate the effect of oral treatment with controlled-release (CR) flecainide administered once daily on AF patients' QoL and treatment compliance during a 12-week period. Methods A total of 70 cardiologists participated in the study enrolling consecutive adult patients with paroxysmal or persistent AF, treated with flecainide CR in the context of a rhythm control strategy. The effect on QoL was assessed by the Canadian Cardiovascular Society Severity of Atrial Fibrillation scale (CCS-SAF) measured at baseline and at 12 weeks of treatment. Results In total, 679 patients (53.2% females, mean age 65.9±11.7 years, 86.9% paroxysmal AF) were included in the analysis. At least one prior antiarrhythmic treatment was documented in 43.8% of patients. The initial daily dose of flecainide CR was 100mg in 71.7% of the patients, with a titration to 200mg by the end of study achieved in 67%. In 93.6% of patients an excellent compliance score (100%) to treatment was recorded at the end of the study period. Treatment with flecainide CR resulted in a significant improvement in QoL as presented in the table. Table 1 CCS-SAF score Baseline (Week 0) End of study visit (Week 12) N=679 N=634 Class 1 (minimal effect on QoL) 343 (50.5) 464 (73.2) Class 2 (minor effect on QoL) 253 (37.2) 140 (22.1) Class 3 (moderate effect on QoL) 73 (10.8) 28 (4.4) Class 4 (severely impairs QoL) 10 (1.5) 2 (0.3) CCS-SAF continuous score Mean ± SD 1.64±0.73 1.32±0.57 Change from baseline‡ Mean (95% CI) −0.325 (−0.379, −0.271) p-value <0.0001 ‡Paired t-test is used. Conclusions This prospective, multicenter, observational study demonstrated that treatment of AF patients with flecainide CR, was associated with a significant improvement of QoL and excellent compliance to treatment. Acknowledgement/Funding Sponsored by WinMedica S.A.

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