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The Cost-Effectiveness of Non-Pharmacologic, Behavioral Intervention in Veterans with Dementia: The Tailored Activity Program

Lim Y, Gitlin LN, Vogel WB, Mann WC. The Cost-Effectiveness of Non-Pharmacologic, Behavioral Intervention in Veterans with Dementia: The Tailored Activity Program. Poster session presented at: Florida Occupational Therapy Association Annual Conference; 2014 Nov 8; Fort Myers, FL.




Abstract:

This study investigates whether the Tailored Activity Program (TAP) reduces healthcare utilization and cost for Veterans with dementia. TAP uses a randomized two-group parallel design of 8 in-home OT visits and 8 telephone support calls. TAP analyzes caregiver-recorded healthcare and health-related costs and VA cost data. It is hypothesized that the TAP intervention will result in a cost-effective means to reduce unwanted behaviors in Veterans with dementia living at home. Learning objectives Neuropsychiatric symptoms are a hallmark of dementia [1] and these symptoms can increase healthcare utilization and costs [2]. The Tailored Activity Program (TAP) uses a randomized two-group parallel design to alleviate unwanted behaviors and to assess the impact of the intervention on Veteran healthcare costs. The Veteran's caregiver completes a cost diary detailing healthcare use and costs during the previous 4-month period. The diaries are collected at 4-month and 8-month interviews. The cost diary is designed to capture costs associated with out-of-pocket expenses, lost work days/salary, and travel expenses that are related to caring for the Veteran in home environments. Total costs of care between the OT-intervention and Attention-Control groups will be compared using existing VA patient-specific cost data (direct costs) and caregiver cost diaries (indirect costs). It is hypothesized that the TAP intervention will result in cost-effective ways to reduce VA costs for Veterans with dementia living at home. Learning Objectives: 1. Introduce the TAP cost-effectiveness design and cost-effectiveness analysis. 2. Explain how the TAP program may reduce healthcare use and costs for Veterans with dementia. 3. Inform occupational therapists about the potential reduction of dementia healthcare use and potential costs associated with a prescriptive behavioral management program. References: APA citation of resources used for your presentation. [1] Gitlin, L. N., Kales, H. C., and Lyketsos, C. G. (2012). Nonpharmacologic management of behavioral symptoms in dementia. Journal of the American Medical Association, 308(19), 2020-2029. doi: DOI 10.1001/jama.2012.36918 [2] Beeri, M. S., Werner, P., Davidson, M., and Noy, S. (2002). The cost of behavioral and psychological symptoms of dementia (BPSD) in community dwelling Alzheimer's disease patients. International Journal of Geriatric Psychiatry, 17(5), 403-408. doi: Doi 10.1002/Gps.490





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