The effectiveness and cost-effectiveness of respite for caregivers of frail older people

TY - JOUR

T1 - The effectiveness and cost-effectiveness of respite for caregivers of frail older people

AU - Mason, Anne

AU - Weatherly, Helen

AU - Spilsbury, Karen

AU - Golder, Su

AU - Arksey, Hilary

AU - Adamson, Joy

AU - Drummond, Michael

N1 - Acknowledgement is given to the Journal of the American Geriatrics Society, The American Geriatrics Society and Blackwell Publishing. Mason, A., Weatherly, H., Spilsbury, K., Golder, S., Arksey, H., Adamson, J. and Drummond, M. (2007) The effectiveness and cost-effectiveness of respite for caregivers of frail older people, Journal of the American Geriatrics Society, 55, 2, 290-99 © 2007, the authors. This is an author produced version of a paper published in Progress in Geriatrics. Uploaded in accordance with the publisher's self-archiving policy.

PY - 2007/2

Y1 - 2007/2

N2 - The proportion of frail elderly people in the industrialized world is increasing. Respite care is a potentially important way of maintaining the quality of life for these people and their caregivers. The objective of this systematic review was to determine the effectiveness and cost-effectiveness of different models of community-based respite care for frail older people and their caregivers. To identify relevant studies, 37 databases were searched, and reference checking and citation searches were undertaken. Well-controlled effectiveness studies were eligible for inclusion, with uncontrolled studies admissible only in the absence of higher-quality evidence. Studies assessed the effect of community-based respite on caregivers of frail elderly people relative to usual care or to another support intervention. Eligible economic evaluations also addressed costs. Where appropriate, data were synthesized using standard meta-analytic techniques. Ten randomized, controlled trials, seven quasi-experimental studies and five uncontrolled studies were included in the review. For all types of respite, the effects upon caregivers were generally small, with better-controlled studies finding modest benefits only for certain subgroups, although many studies reported high levels of caregiver satisfaction. No reliable evidence was found that respite care delays entry to residential care or adversely affects frail older people. The economic evaluations all assessed day care, which tended to be associated with similar or higher costs than usual care. Given the increasing numbers of frail elderly people and the lack of up-to-date, good-quality evidence for all types of respite care, better-quality evidence is urgently needed to inform current policy and practice.

AB - The proportion of frail elderly people in the industrialized world is increasing. Respite care is a potentially important way of maintaining the quality of life for these people and their caregivers. The objective of this systematic review was to determine the effectiveness and cost-effectiveness of different models of community-based respite care for frail older people and their caregivers. To identify relevant studies, 37 databases were searched, and reference checking and citation searches were undertaken. Well-controlled effectiveness studies were eligible for inclusion, with uncontrolled studies admissible only in the absence of higher-quality evidence. Studies assessed the effect of community-based respite on caregivers of frail elderly people relative to usual care or to another support intervention. Eligible economic evaluations also addressed costs. Where appropriate, data were synthesized using standard meta-analytic techniques. Ten randomized, controlled trials, seven quasi-experimental studies and five uncontrolled studies were included in the review. For all types of respite, the effects upon caregivers were generally small, with better-controlled studies finding modest benefits only for certain subgroups, although many studies reported high levels of caregiver satisfaction. No reliable evidence was found that respite care delays entry to residential care or adversely affects frail older people. The economic evaluations all assessed day care, which tended to be associated with similar or higher costs than usual care. Given the increasing numbers of frail elderly people and the lack of up-to-date, good-quality evidence for all types of respite care, better-quality evidence is urgently needed to inform current policy and practice.

KW - respite care

KW - frail elderly

KW - caregivers

KW - review

KW - costs and cost analysis

KW - ADULT DAY-CARE

KW - ELDERLY-PEOPLE

KW - DEMENTIA CAREGIVERS

KW - ALZHEIMERS PATIENTS

KW - HOME

KW - FAMILY

KW - INTERVENTIONS

KW - SERVICE

KW - METAANALYSIS

KW - REDUCTION

U2 - 10.1111/j.1532-5415.2006.01037.x

DO - 10.1111/j.1532-5415.2006.01037.x

M3 - Article

C2 - 17302669

SN - 0002-8614

VL - 55

SP - 290

EP - 299

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

IS - 2

ER -