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Objectives: The MEETINGDEM research project aimed to implement the combined Dutch Meeting Centre Support Programme (MCSP) for community-dwelling people with dementia and caregivers within Italy, Poland and UK and to assess whether comparable benefits were found in these countries as in the Netherlands. Method: Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared to usual care (UC) on caregiver outcomes measuring competence (SSCQ), mental health (GHQ-12), emotional distress (NPI-Q) and loneliness (UCLA) analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. Interviews using standardised measures were completed with caregivers. Results: Pre/post data were collected for 93 caregivers receiving MCSP and 74 receiving UC. No statistically significant differences on the outcome measures were found overall. At a country level MC caregivers in Italy showed significant better general mental health (p = 0.04, d = 0.55) and less caregiver distress (p = 0.02, d = 0.62) at post-test than the UC group. Caregiver satisfaction was rated on a sample at 3 months (n = 81) and 6 months (n = 84). The majority of caregivers reported feeling less burdened and more supported by participating in MCSP. Conclusion: The moderate positive effect on sense of competence and the greater mental health benefit for lonely caregivers using the MCSP compared to UC as found in the original Dutch studies were not replicated. However, subject to study limitations, caregivers in Italy using MCSP benefitted more regarding their mental health and emotional distress than caregivers using UC. Further evaluation of the benefits of MCSP within these countries in larger study samples is recommended.

Many governments have introduced or encouraged home-care reablement schemes for older people at home with the aim of improving outcomes and reducing costs. We examined if such schemes have the potential to reduce costs from the perspective of the National Health Service (NHS) and Personal Social Services (PSS) in England. Our study was carried out to inform recommendations of a national guideline. Cost-minimisation analysis was carried out using decision-analytic Markov modelling. Home-care reablement was compared with standard home care. Costs included those of the intervention, home care and hospital admission. Uncertainty was explored using univariate and probabilistic sensitivity analysis. Mean costs per person were £56,499 (95% confidence interval 55,690 to 57,307) in the reablement group, and £58,560 (95% confidence interval 57,800 to 59,319) in the standard care group. The mean difference was -£2,061 (95% confidence interval 1,933 to 2,129). The probability that home-care reablement costs less than standard home care was 94.5% (95% confidence interval 93.1 to 95.9). In sensitivity analyses, this probability remained above 85% in all scenarios. Home-care reablement can be a successful cost-minimisation strategy for supporting some older people. More research is needed about the impact of home-care reablement on health outcomes for different groups of older people; and the effects of different durations of reablement on outcomes and costs for different subpopulations.

MEETINGDEM focussed on the adaptive implementation and evaluation of the successful Dutch Meeting Centres Support Programme (MCSP) for community dwelling people with dementia and their carers. MEETINGDEM took the learning from the Dutch experience to assess whether it would work in Italy, Poland and UK. Each country established at least two Meeting Centres (MC). Implementation facilitators and barriers were inventoried. User satisfaction, cost effectiveness and effectiveness was compared to usual care (UC) and evaluated in a 7 months pre/post controlled trial. 13 MC’s were successfully implemented. Users reported high satisfaction. After six months MC participants showed significant positive effects on QoL (self-esteem, positive affect and feelings of belonging). No significant differences were found for depression or social inclusion. MC carers reported significantly reduced loneliness. MC costs, including intervention costs, were higher than those in the UC group, showing that the benefits of MCSP are associated with additional costs.