MODEM

We have gathered new evidence on the lives of people with dementia and their carers, and interventions that could delay onset, slow deterioration in cognition, functioning or behaviour, or reduce their adverse impacts on wellbeing, and on costs.

 

The evidence was collected through literature reviews, data from previous and ongoing trials and observational studies, primary data from a new cohort, qualitative interviews and focus groups. 

 

The literature review is helping to inform the development of the conceptual, framework, empirical model architecture and estimation of parameters for decision modelling. It has focused on identifying the state of the art on the efficacy, effectiveness, resource consequences and cost-effectiveness of interventions to prevent or delay dementia onset, reduce symptom severity or improve quality of life of people with dementia and their carers. This took the form of a review of previously published systematic reviews and meta-analyses.

 

In addition, we have conducted a supplemental search to identify further resource, costing and economic analyses (including model-based studies) for interventions identified in our review of reviews. We made use of and adapted past search strategies including those that we have designed to identify systematic reviews and economic evaluations. Where possible effect sizes and 95% confidence intervals were reported, otherwise a narrative summary has been provided.

 

In addition to informing other aspects of our study, a further output will be the publication of a paper summarising the review’s findings. There may also be a second paper focused solely on economic issues identified in the review. 

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Findings:

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Dixon J, Knapp M, Karagiannidou M (2018) The effectiveness of advance care planning in improving end of life outcomes for people with dementia and their carers: A systematic review and critical discussion, Journal of Pain and Symptom Management, 55 , 1 , 132-150

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The Dementia Evidence Toolkit is a web-based resource consisting of:

• A searchable coded bibliographic database of 3000 empirical papers and 700 systematic reviews on interventions for the treatment, care and support of people with dementia and carers, comprising the period between 2009 and June 2015.

• Plain language summaries of the evidence on the effectiveness (and cost-effectiveness) of key care and treatment interventions.