Short Term Economic Evaluation of the Digital Platform "Support, Monitoring and Reminder Technology for Mild Dementia" (SMART4MD) for People with Mild Cognitive Impairment and their Informal Caregivers

BACKGROUND: A randomized controlled trial of the SMART4MD tablet application was conducted for persons with mild cognitive impairment (PwMCI) and their informal caregivers to improve or maintain quality of life. OBJECTIVE: The objective was to conduct economic evaluation of SMART4MD compared to standard care in Sweden from a healthcare provider perspective based on a 6-month follow-up period. METHODS: Three hundred forty-five dyads were enrolled: 173 dyads in the intervention group and 172 in standard care. The primary outcome measures for PwMCI and informal caregivers were quality-adjusted life years (QALY). The results are presented as incremental cost-effectiveness ratios, and confidence intervals are calculated using non-parametric bootstrap procedure. RESULTS: For PwMCI, the mean difference in total costs between intervention and standard care was € 12 (95% CI: -2090 to 2115) (US$ = € 1.19) and the mean QALY change was -0.004 (95% CI: -0.009 to 0.002). For informal caregivers, the cost difference was - € 539 (95% CI: -2624 to 1545) and 0.003 (95% CI: -0.002 to 0.008) for QALY. The difference in cost and QALY for PwMCI and informal caregivers combined was -€ 527 (95% CI: -3621 to 2568) and -0.001 (95% CI: -0.008 to 0.006). Although generally insignificant differences, this indicates that SMART4MD, compared to standard care was: 1) more costly and less effective for PwMCI, 2) less costly and more effective for informal caregivers, and 3) less costly and less effective for PwMCI and informal caregivers combined. CONCLUSION: The cost-effectiveness of SMART4MD over 6 months is inconclusive, although the intervention might be more beneficial for informal caregivers than PwMCI.CC BY-NC 4.0Correspondence to: Zartashia Ghani, PhD-Candidate, Applied Health Technology, Department of Health, Blekinge Institute of Technology, Lumavägen 1, 371 50 Karlskrona, Sweden. Tel.: 0046733420237; E-mail: zartashia.ghani@bth.se.The authors are grateful to everyone who volunteered to participate in the SMART4MD trial as well as the staff for their collaboration in data collection and management. The authors are also grateful to Region Blekinge for provision of healthcare utilization data. This study is part of SMART4MD (Support Monitoring and Reminder Technology for Mild Dementia), European Commission, Horizon 2020 project 643399 (www.smart4md.eu). We greatly acknowledge the financial support. Neither the financial sponsor nor Healthbit Ltd played any role in the design, execution, analysis and interpretation of data, write-up of the study, or the decision to publish. Authors’ disclosures available online (https://www.j-alz.com/manuscript-disclosures/21-5013r2).SMART4MD (Support Monitoring and Reminder Technology for Mild Dementia