Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial.

摘要: Objective To assess whether the START (STrAtegies for RelatTives) intervention added to treatment as usual is cost effective compared with alone. Design Cost effectiveness analysis nested within a pragmatic randomised controlled trial. Setting Three mental health and one neurological outpatient dementia service in London Essex, UK. Participants Family carers of people dementia. Intervention Eight session, manual based, coping delivered by supervised psychology graduates family treatment, alone. Primary outcome measures Costs measured from social care perspective were analysed alongside Hospital Anxiety Depression Scale total score (HADS-T) affective symptoms quality adjusted life years (QALYs) analyses over eight months baseline. Results Of 260 participants recruited study, 173 intervention, 87 alone. Mean HADS-T scores lower group than 8 month evaluation period (mean difference −1.79 (95% CI −3.32 −0.33)), indicating better outcomes associated intervention. There was small improvement related QALYs (0.03 (−0.01 0.08)). no different between groups (£252 (−28 565) higher group). The calculations suggested that had greater 99% chance being alone at willingness pay threshold £30 000 per QALY gained, high probability on measure. Conclusions based START, when usual, reference both (affective carers, carer QALYs). Trial Registration ISCTRN 70017938