Effects of in-person and telephone-based cognitive behavioral therapies on health services use and expenditures among African-American dementia caregivers with depressive symptoms

Bibliographic Data

ID12554256
AuthorsHongdao Meng (0000-0003-4551-9562, University of South Florida, corresponding author), Victoria Marino (0000-0001-8403-6083, University of South Florida, corresponding author), Kyaien O Conner (0000-0003-4278-861X, University of South Florida), Dinesh Sharma (0000-0002-6647-1513, James Madison University), Dinesh C Sharma (0000-0003-4731-3269, James Madison University), William S Davis (0000-0002-2359-0387, Florida State University), Robert L Glueckauf (0000-0003-2864-9525, Florida State University)
Year2019
Volume26
Issue6
Pages879-892
Publication date2019-03-19
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueEthnicity and Health (JOURNAL)
Journal identifiersISSN: 1355-7858 • E-ISSN: 1465-3419
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/13557858.2019.1590536
PMID30884961
OpenAlexW2924076410
LanguageEN
Citations received1
References cited47

Objectives: To compare the effects of telephone-based and in-person cognitive behavioral therapy (CBT) on health services use and expenditures among African-American dementia caregivers (CGs) with depressive symptoms. Methods: We analyzed data collected from 109 caregivers in a randomized controlled trial comparing the effects of telephone-based and in-person CBT on health services use and costs. Study participants were assigned randomly to either telephone or in-person CBT. Data were collected one week before and one week after the 12-week intervention. The Health Service Composite (HSC) was used to collect information on health services (physical and mental health, emergency room, hospital) utilization and associated expenditures. Intervention cost data were collected using micro-costing analysis. We used generalized linear models to examine whether the two groups differed in total health care expenditures over the six-month study period. Results: CG characteristics and health services use were similar at pre-intervention. CGs' monthly health expenditures averaged $924 and $844 in the in-person and telephone-based groups, respectively. However, intervention costs were lower for telephone-based than in-person CBT. Adjusting for CG characteristics and pre-intervention health status, there were no statistically significant differences in average monthly expenditures between the two intervention groups across time. Discussion: Findings suggest that while telephone-based CBT offers more participation flexibility, it has a similar cost profile as compared to the in-person CBT. Despite the lack of cost saving, telephone-based CBT may be an important option for providing skills building and support to older African-American family CGs with barriers to access resources for respite care and transportation

Dementia · Disease · Health care · Intervention (counseling · Mental health · Psychiatry · Randomized controlled trial · Telephone counseling · Dementia and Cognitive Impairment Research · Family Caregiving in Mental Illness · Geriatric Care and Nursing Homes · Medicine · Gerontology