Clinically effective NIDUS-Family support programme would save the NHS and social care £9000/yr per person with dementia
Results from a randomised controlled trial show that NIDUS-Family, a remotely delivered personalised care and support intervention for people with dementia, is cost-effective, and would save the NHS and social care an average of £9000 a year for each person with dementia. Researchers say that the intervention, already shown to be clinically effective from the perspective of the quality of life of people with dementia, should be part of routine dementia care.
The study, published in Lancet Healthy Longevity, shows that people with dementia who took part in the NIDUS-Family intervention cost the NHS and social care £8934 (37%) less on average over one year than people who did not receive the additional help. These cost savings were achieved through the person receiving the intervention spending less time in hospital and using less state-funded social care, compared with controls, costs of which far exceeded the modest £346 annual cost of this preventive intervention.
Designed by WIPH researchers, NIDUS-Family is a package of care and support focusing on practical changes people can make, with sessions built around the specific priorities of the person with dementia - such as increasing time spent in enjoyable activities, improving sleep, or for carers to have more time to focus on their own wellbeing. It can be delivered to the person with dementia and family carer together, or the family carer alone, by phone, video-call or in person.
The NIDUS-Family randomised controlled trial, led by Professor Claudia Cooper (WIPH) and funded by Alzheimer’s Society, found that family carers and the people with dementia they supported who received the NIDUS-Family intervention were significantly more likely to achieve the goals they set than those who received their usual care over a year. This was true whether the intervention was delivered by video-call, telephone, or in-person.
Around 982,000 people in the UK have dementia, and the costs of providing dementia support across health and social care are expected to rise to £90 billion by 2040. Finding ways to support people with dementia to continue to live in their own homes is likely to improve wellbeing, reduce inequalities in accessing treatment, and be cost-effective. Although current national guidelines recommend that everyone with dementia receives personalized, post-diagnostic support, few do. Nearly two-thirds (61%) of those aged over 65 with dementia in the UK live in their own homes, rather than in care homes. However, unmet needs, poor self-care, home safety risks and burden reported by family carers are common reasons necessitating a move to a care home.
Professor Claudia Cooper said: ‘The new therapy has the potential to be rolled out to support consistent, evidence-based personalised dementia care across the NHS. Given NIDUS-family helps people with dementia and their families, and also costs less, it should be widely available within routine care.’
Dr Richard Oakley, Associate Director of Research and Innovation at Alzheimer’s Society, said: ‘The NIDUS-Family programme is a game-changing intervention for people with dementia, and we’re really proud to have funded this work as part of Alzheimer’s Society’s Centres of Excellence initiative. This research shows we have at our fingertips a cost-effective, realistic solution offering people living with dementia access to tailored, personalised support to achieve their own goals, which we would like to see as an option in routine care.’
Abdinasir Isaaq, Claudia Cooper, Victoria Vickerstaff, Julie A. Barber, Kate Walters, Iain A. Lang, Penny Rapaport, Vasiliki Orgeta, Kenneth Rockwood, Laurie T Butler, Kathryn Lord, Gill Livingston, Sube Banerjee, Jill Manthorpe, Helen C. Kales, Jessica Budgett, Rachael Hunter. Cost-utility of a new psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family) versus goal-setting and routine care: economic evaluation embedded within a randomised controlled trial. The Lancet Healthy Longevity 29 January 2025. DOI: 10.1016/j.lanhl.2024.100676