PMID- 34536149
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240403
IS  - 2191-1991 (Print)
IS  - 2191-1991 (Electronic)
IS  - 2191-1991 (Linking)
VI  - 11
IP  - 1
DP  - 2021 Sep 18
TI  - Which factors increase informal care hours and societal costs among caregivers of 
      people with dementia? A systematic review of Resource Utilization in Dementia 
      (RUD).
PG  - 37
LID - 10.1186/s13561-021-00333-z [doi]
LID - 37
AB  - BACKGROUND: Nearly 19 million people across OECD countries are living with 
      dementia, and millions of family caregivers are affected by the disease. The 
      costs of informal care are estimated to represent 40-75% of the total dementia 
      cost exceeding formal care time and medical costs. OBJECTIVE: To conduct a 
      systematic review to evaluate the methodological quality and factors associated 
      with high informal care hours per month that increase societal costs, and to 
      identify what type of interventions may alleviate the entire burden of informal 
      and formal caregiving. METHODS: The systematic review was registered at PROSPERO 
      (15.12.2020). A search in Medline, Embase, PsycINFO, and web of science for 
      observational studies, cost-effectiveness, and cost of illness (COI) analyses on 
      resource utilization in dementia (RUD) was conducted on 1 December 2020. Our 
      inclusion criteria included a requirement that studies had to use the original 
      RUD, RUD-FOCA or RUD lite in terms of hours or days per month, and costs as 
      primary or secondary outcome, OECD countries, within the last 20 years and a 
      sample population comprising persons with dementia (PwD) >/=65 years and their 
      caregivers. We followed the PRISMA, GRADE, PICO guidelines and Drummond criteria 
      to assess the methodology and quality of the studies. RESULTS: Of 307 studies, 26 
      cross-sectional and 3 longitudinal cohort studies were included in the analyses. 
      Two studies had a randomized controlled trial (RCT) design. The methods and cost 
      categories in each study varied widely. Disease severity, caregiver factors, and 
      behavioural and psychological symptoms of dementia (BPSD) were associated with 
      high informal care hours and societal cost. One RCT found no effect of a 
      non-pharmacological intervention on informal care hours, yet another RCT found a 
      cost-effective impact of an in-home respite care programme reducing informal care 
      burden and costs. CONCLUSION: The divergent use of the RUD components within 
      included studies encourage more harmonized analyses. There are only two RCTs on 
      RUD, one of which shows a significant treatment effect. Larger sample sizes and 
      longer follow-up periods are required in future RCTs with dedicated focus on 
      cost-enhancing and resource intensive factors such as disease severity and BPSD. 
      Novel interventions must diversify between caregiver and PwD groups. PROSPERO 
      REGISTRATION: CRD42021226388 .
CI  - (c) 2021. The Author(s).
FAU - Angeles, Renira C
AU  - Angeles RC
AUID- ORCID: 0000-0002-1648-2601
AD  - NORCE Norwegian Research Centre AS, Department of Social Science, Health Services 
      and Health Economics Research Group, Bergen, Norway. renira.angeles@uib.no.
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      and Primary Care, University of Bergen, Bergen, Norway. renira.angeles@uib.no.
FAU - Berge, Line I
AU  - Berge LI
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      and Primary Care, University of Bergen, Bergen, Norway.
AD  - NKS Olaviken Gerontopsychiatric Hospital, Askoy, Norway.
FAU - Gedde, Marie H
AU  - Gedde MH
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      and Primary Care, University of Bergen, Bergen, Norway.
AD  - Haraldsplass Deaconess Hospital, Bergen, Norway.
FAU - Kjerstad, Egil
AU  - Kjerstad E
AD  - NORCE Norwegian Research Centre AS, Department of Social Science, Health Services 
      and Health Economics Research Group, Bergen, Norway.
FAU - Vislapuu, Maarja
AU  - Vislapuu M
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      and Primary Care, University of Bergen, Bergen, Norway.
FAU - Puaschitz, Nathalie G
AU  - Puaschitz NG
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      and Primary Care, University of Bergen, Bergen, Norway.
AD  - Centre for Care Research West, Western Norway University of Applied Sciences, 
      Bergen, Norway.
FAU - Husebo, Bettina S
AU  - Husebo BS
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      and Primary Care, University of Bergen, Bergen, Norway.
AD  - Municipality of Bergen, Bergen, Norway.
LA  - eng
GR  - 273581/Norges Forskningsrad/
GR  - 273581/Norges Forskningsrad/
GR  - 273581/Norges Forskningsrad/
GR  - 273581/Norges Forskningsrad/
GR  - 273581/Norges Forskningsrad/
PT  - Journal Article
PT  - Review
DEP - 20210918
PL  - Germany
TA  - Health Econ Rev
JT  - Health economics review
JID - 101583209
PMC - PMC8449888
OTO - NOTNLM
OT  - Cost of illness
OT  - Cost-effectiveness
OT  - Family caregivers
OT  - Informal caregivers
OT  - Resource utility dementia
COIS- MHG, LIB, BSH, MV, EK and RCA declare no competing interests.
EDAT- 2021/09/19 06:00
MHDA- 2021/09/19 06:01
PMCR- 2021/09/18
CRDT- 2021/09/18 12:08
PHST- 2021/05/31 00:00 [received]
PHST- 2021/08/30 00:00 [accepted]
PHST- 2021/09/18 12:08 [entrez]
PHST- 2021/09/19 06:00 [pubmed]
PHST- 2021/09/19 06:01 [medline]
PHST- 2021/09/18 00:00 [pmc-release]
AID - 10.1186/s13561-021-00333-z [pii]
AID - 333 [pii]
AID - 10.1186/s13561-021-00333-z [doi]
PST - epublish
SO  - Health Econ Rev. 2021 Sep 18;11(1):37. doi: 10.1186/s13561-021-00333-z.