The use of smartphone applications in healthcare (mHealth) has opened an opportunity to support PwMCI’s self-care as well as making them habituated with the technology that can be useful in the later stage of the disease progression. Moreover, mHealth might be useful to ease the burden of informal caregivers, as the well-being of informal caregivers is important due to his/her central role in the care chain. With an increasing number of people living with dementia in aging societies, cost-effective interventions that can facilitate aging in the home environment and reduce the burden of informal caregivers are of great importance.
This project aims to estimate if a smartphone intervention designed to improve the quality of life and ease caregivers' burden for people with mild cognitive impairment and their informal caregivers was cost-effective from a healthcare perspective. The cost-effective analysis can assist policymakers to take informed decision on the use of smartphone application for the management of people living with dementia as well as their caregivers.
A pragmatic randomized trial was conducted in three sites of two different countries, Sweden, and Spain, for people with mild cognitive impairment (PwMCI) together with their informal caregivers. 1078 dyads consisting of PwMCI and his/her main informal caregiver participated in the trial. The intervention group received a smartphone application (SMART4MD) specifically designed for people with mild dementia based on input through interviews from PwMCI, their informal caregivers, and healthcare professionals.
Some important features of this app include reminders (e.g., medication, healthcare appointments), cognitive support (e.g., cognitive-stimulating games and photographs), and an optional function where health information can be shared with family and informal caregivers (e.g., daily feeling, specific health problems and quality of life). The control group received country-specific standard of care. The duration of intervention was 18 months and information was collected regarding participants’ health-related quality of life, caregivers' burden together with sociodemographic characteristics at the baseline, 6 months, and end of the trial.
The purpose of the AppDem project is to estimate whether the intervention provided in the SMART4MD trial was cost-effective or not from the healthcare perspective. Furthermore, we want to study whether the intervention was cost-effective for PwMCI, for informal caregivers, or for the dyads, and whether it is cost-effective in Sweden or Spain or in both countries.