Cost-consequence analysis of an intervention for the management of neuropsychiatric symptoms in young-onset dementia: Results from the BEYOND-II study

Jeannette C. L. van Duinen-van den IJssel, Christian Bakker*, Martin Smalbrugge, Sandra A. Zwijsen, Eddy Adang, Britt Appelhof, Sytse U. Zuidema, Marjolein E. de Vugt, Frans R. J. Verhey, Raymond T. C. M. Koopmans

*Corresponding author for this work

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Objective To evaluate the cost-consequences of an intervention for the management of neuropsychiatric symptoms in nursing home residents with young-onset dementia. Methods A stepped wedge design was used. The intervention consisted of an educational program and a multidisciplinary care program and was implemented in 13 nursing homes from September 2015 to March 2017. Costs' outcomes included the time investment of the elderly care physician and health care psychologists regarding the management of neuropsychiatric symptoms, residents' psychotropic drug use, nursing staff absenteeism, and costs of the educational program. Composite cost measure contained the sum of costs of staff absenteeism, costs on psychotropic drugs, and costs of the educational program. Costs of time investment were investigated by comparing means. Costs of psychotropic drug use were analyzed with mixed models at resident level and as part of the composite cost measure on unit level. Staff absenteeism was also analyzed at unit level. Results Compared with care as usual, the mean costs of time invested decreased with euro36.79 for the elderly care physician but increased with euro46.05 for the health care psychologist in the intervention condition. Mixed model analysis showed no effect of the intervention compared with care as usual on the costs of psychotropic drug use, staff absenteeism, and the composite cost measure. The costs of the educational program were on average euro174.13 per resident. Conclusion The intervention did not result in increased costs compared with care as usual. Other aspects, such as the lack of a structured working method, should be taken into account when considering implementation of the intervention.

Original languageEnglish
Pages (from-to)131-137
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Issue number1
Early online date7 Nov 2019
Publication statusPublished - Jan 2020


  • cost-consequence analysis
  • neuropsychiatric symptoms
  • nursing home
  • psychosocial intervention
  • young-onset dementia
  • CARE
  • NEED

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