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Boland E, Fitzpatrick R, Ryan D, Kane J, Betzhold S, Leroi I, Kinchin I. The high cost of care and limited evidence on cost-effective strategies for Lewy body dementia: systematic review of evidence. BJPsych Open 2024; 10:e20. [PMID: 38179602 PMCID: PMC10790215 DOI: 10.1192/bjo.2023.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Lewy body dementia (LBD) is a prevalent yet frequently underdiagnosed form of dementia, accounting for up to 15% of all dementia cases. AIMS This study aims to increase awareness and advocacy for LBD by gathering and critically assessing the economic evidence, including the cost of illness and cost-effectiveness of interventions for managing LBD. METHOD A systematic literature review was undertaken with EMBASE, Medline, CINAHL, PsycINFO, NHS Economic Evaluation Database and EconLit. This search was supplemented by grey literature on Google Scholar and reviewing the reference lists of identified studies. The papers included in the review were published between 2008 and 2023, and involved participants with LBD (dementia with Lewy bodies or Parkinson's disease dementia), which either addressed the cost of illness or conducted an economic evaluation. RESULTS Thirteen papers were included, comprising ten cost-of-illness studies and three economic evaluations. The cost of LBD tends to be higher than that of other forms of dementia, such as Alzheimer's disease, and these costs escalate more steeply as the disease progresses. These cost differences may not be solely influenced by the subtype of dementia, but possibly also by patient characteristics like physical and cognitive abilities. Cost-effectiveness of potential interventions for LBD is limited. CONCLUSIONS Despite numerous drug trials and other interventions for dementia, very few have targeted LBD, let alone explored the cost-effectiveness of such therapies for LBD. This disparity highlights the urgent need for cost-effective strategies and interventions targeting LBD. We propose the establishment of universally accepted standards for LBD research.
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Affiliation(s)
- Erin Boland
- Trinity College Institute of Neuroscience, School of Medicine, Trinity College Dublin, Ireland
| | - Rachel Fitzpatrick
- Trinity College Institute of Neuroscience, School of Medicine, Trinity College Dublin, Ireland
| | - Dearbhail Ryan
- Trinity College Institute of Neuroscience, School of Medicine, Trinity College Dublin, Ireland
| | - Joseph Kane
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, UK
| | - Sara Betzhold
- Faculty of Health Sciences, Trinity College Dublin, Ireland
| | - Iracema Leroi
- Trinity College Institute of Neuroscience, School of Medicine, Trinity College Dublin, Ireland; and Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Irina Kinchin
- Centre for Health Policy and Management, Trinity College Dublin, Ireland
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Grycuk E, Eichenholtz E, Aarsland D, Betzhold S, Daly G, Fitzpatrick R, Folkerts AK, Kalbe E, Kane JPM, Kinchin I, Saldanha IJ, Smith V, Taylor JP, Thompson R, Leroi I. Developing a core outcome set (COS) for Dementia with Lewy bodies (DLB). HRB Open Res 2023; 5:57. [PMID: 36619176 PMCID: PMC9772580 DOI: 10.12688/hrbopenres.13590.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 10/13/2023] Open
Abstract
Background: Dementia with Lewy bodies (DLB) is an important cause of dementia with a range of clinical manifestations, including motor, neuropsychiatric, and autonomic symptoms. Compared with more common forms of dementia such as Alzheimer's disease, DLB has been the focus of significantly fewer treatment studies, often with diverse outcome measures, making comparison and clinical implementation difficult. A core outcome set (COS) can address this by ensuring that data are comparable, relevant, useful, and usable for making the best healthcare decisions. Methods: Using a multi-stage approach, development of the DLB-COS will include the following stages: (1) A systematic review, following PRISMA guidelines to create an initial long list of outcomes; (2) A two-round online Delphi including clinicians, scientists, policymakers, and individuals with lived experience of DLB and their representatives; (3) An online consensus meeting to agree on the final core list of outcomes (the final DLB-COS) for use in research and clinical practice; (4) A systematic review to identify appropriate measurement instruments for the DLB-COS outcomes; (5) A final consensus meeting of the professional stakeholders who attended the online consensus meeting to agree on the instruments that should be used to measure the outcomes in the DLB-COS; and (6) Global dissemination. Discussion: This is a multi-stage project to develop a COS to be used in treatment trials for DLB. A DLB-COS will ensure the selection of relevant outcomes and will identify the instruments to be used to measure DLB globally. Keywords: Dementia, Dementia with Lewy Bodies, Core Outcome Set, Delphi, Systematic Review, Ageing, Cognition, Memory.
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Affiliation(s)
- Emilia Grycuk
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland
| | - Emily Eichenholtz
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Dag Aarsland
- Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | | | - Gillian Daly
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Rachel Fitzpatrick
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Joseph PM Kane
- Centre for Public Health, Queens University Belfast, Northern Ireland, UK
| | - Irina Kinchin
- Global Brain Health Institute, and Centre for Health Policy and Management, Trinity College, Dublin, Ireland
| | | | - Valerie Smith
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, UK
| | | | - Iracema Leroi
- Global Brain Health Institute, and Department of Psychiatry, Trinity College Dublin, Ireland
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Grycuk E, Eichenholtz E, Aarsland D, Betzhold S, Daly G, Fitzpatrick R, Folkerts AK, Kalbe E, Kane JPM, Kinchin I, Saldanha IJ, Smith V, Taylor JP, Thompson R, Leroi I. Developing a core outcome set (COS) for Dementia with Lewy bodies (DLB). HRB Open Res 2022; 5:57. [PMID: 36619176 PMCID: PMC9772580 DOI: 10.12688/hrbopenres.13590.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Dementia with Lewy bodies (DLB) is an important cause of dementia with a range of clinical manifestations, including motor, neuropsychiatric, and autonomic symptoms. Compared with more common forms of dementia such as Alzheimer's disease, DLB has been the focus of significantly fewer treatment studies, often with diverse outcome measures, making comparison and clinical implementation difficult. A core outcome set (COS) can address this by ensuring that data are comparable, relevant, useful, and usable for making the best healthcare decisions. Methods: Using a multi-stage approach, development of the DLB-COS will include the following stages: (1) A systematic review, following PRISMA guidelines to create an initial long list of outcomes; (2) A two-round online Delphi including clinicians, scientists, policymakers, and individuals with lived experience of DLB and their representatives; (3) An online consensus meeting to agree on the final core list of outcomes (the final DLB-COS) for use in research and clinical practice; (4) A literature search to identify appropriate measurement instruments for the DLB-COS outcomes; (5) A final consensus meeting of the professional stakeholders who attended the online consensus meeting to agree on the instruments that should be used to measure the outcomes in the DLB-COS; and (6) Global dissemination. Discussion: This is a multi-stage project to develop a COS to be used in treatment trials for DLB. A DLB-COS will ensure the selection of relevant outcomes and will identify the instruments to be used to measure DLB globally.
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Affiliation(s)
- Emilia Grycuk
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland
| | - Emily Eichenholtz
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Dag Aarsland
- Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | | | - Gillian Daly
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Rachel Fitzpatrick
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Joseph PM Kane
- Centre for Public Health, Queens University Belfast, Northern Ireland, UK
| | - Irina Kinchin
- Global Brain Health Institute, and Centre for Health Policy and Management, Trinity College, Dublin, Ireland
| | | | - Valerie Smith
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, UK
| | | | - Iracema Leroi
- Global Brain Health Institute, and Department of Psychiatry, Trinity College Dublin, Ireland
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Delgado G, Kaplán E, Simonetti L, Betzhold S, Espinoza R, Berho P, Escalona M. [Hysterectomy in obstetrics]. Rev Chil Obstet Ginecol 1965; 30:49-50. [PMID: 5869496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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