Dementia Care Research and Psychosocial Factors

Area of Science:

• Gerontology
• Neuroscience
• Pharmacology

Background:

• Behavioral and psychological symptoms of dementia (BPSD) are prevalent in Alzheimer's disease, causing distress and increasing healthcare costs.
• Current medications for BPSD are often ineffective and expensive, with newer drugs like Brexpiprazole having high retail prices.
• Acetylcholinesterase inhibitors (ACHI) show potential for ameliorating BPSD but are underutilized by community physicians.

Purpose of the Study:

• To evaluate the cost savings associated with the comprehensive, individualized person-centered management (CI-PCM) program in Alzheimer's disease patients.
• To determine if differential Acetylcholinesterase inhibitor (ACHI) usage contributed to the observed improvements in BPSD within the CI-PCM group.

Main Methods:

• A 28-week randomized controlled trial compared the CI-PCM program with a control group in moderate-to-severe Alzheimer's patients.
• Medication usage, including psychotropic drugs and ACHI, was tracked, and costs were standardized using retail drug pricing.
• The Behavioral Pathology in Alzheimer's Disease Frequency Weighted Severity Scale assessed BPSD, and psychotropic medication costs were calculated at baseline and follow-up visits.

Main Results:

• CI-PCM subjects incurred significantly lower total psychotropic medication costs ($8,804.69) compared to the comparator group ($24,901) from baseline to 28 weeks.
• No statistically significant differences were found between groups regarding Acetylcholinesterase inhibitor (ACHI) usage or its associated costs.
• CI-PCM subjects experienced significant BPSD reduction, while the comparator group showed worsening symptoms.

Conclusions:

• The CI-PCM program leads to substantial cost savings for Alzheimer's patients with BPSD, averaging $1,609.63 per subject.
• Improvements in BPSD within the CI-PCM group were not attributable to differences in ACHI usage.
• CI-PCM offers a cost-effective approach to managing BPSD, alongside demonstrated clinical benefits.