In a recent study published in BMC Public Health, researchers assess the worth and cost-effectiveness of arts and creativity interventions (ACIs) on the health and well-being of older adults.
Study: Arts and creativity interventions for improving health and well-being in older adults: a scientific literature review of economic evaluation studies. Image Credit: Krakenimages.com / Shutterstock.com
Supporting healthy aging
The proportion of the older adult population has increased in almost every country over the past several a long time. An aging population reflects considered one of the successes of public health; nevertheless, it has quite a few economic implications.
Equitable and sustained investment in health and well-being- is obligatory to foster healthy aging and augment older individuals’ lives, families, and communities. Several studies have reported the positive effects of ACIs on health and well-being-, as ACIs can improve older adults’ quality of life, cognitive function, and well-being-. Nonetheless, no systematic review has collated data regarding the worth, cost, and cost-effectiveness of ACIs.
Concerning the study
In the current study, researchers examine the economic effects of ACIs on the health and well-being- of older adults. Medline, Embase, PubMed, Web of Science, Econlit, the National Health Service Economic Evaluation Database (NHSEED), and clinical trial registries were looked for relevant studies.
Studies were eligible if participants were 50 years of age and older. Interventions included performance art resembling singing, dance, drama, or theater, visual and inventive arts including sculpture, painting, or art design, and inventive writing like storytelling or writing poetry/narratives. All interventions were energetic, requiring the older adults to create art slightly than view it. Moreover, all interventions needed to be delivered under skilled guidance.
Cost-effectiveness, cost-minimization, cost-benefit, and cost-utility analyses were performed. Social value analyses were also included in the event that they were used to tell decision-making and commissioning of services.
Two health economists performed title/abstract screening and reviewed full texts. Two reviewers extracted data on sample size, demographics, health, interventions, their effectiveness and costs, kinds of economic evaluations, advantages, quality assessment, results, and conclusions. Study quality was assessed independently by two reviewers.
Partial and full trial-based economic evaluations were analyzed using the Consensus Health Economic Criteria (CHEC)-extended checklist. Social return on investment (SROI) analyses were evaluated using an SROI-specific quality framework.
A narrative synthesis evaluation was performed given the small variety of evaluations, the opportunity of heterogeneity, and the dearth of consensus on methods to pool cost-effectiveness estimates.
Over 11,000 records were identified in database searches. After de-duplication and extra rounds of screening, six studies were included within the review.
Of the included studies, two implemented health technology assessment (HTA) together with clinical trials to look at the cost-effectiveness of community singing. These two studies secured high scores on the CHEC-extended checklist.
The remaining 4 studies employed SROI analyses to guage art and craft interventions. These studies adhered well to suggestions for performing an SROI and scored highly.
Five studies were conducted in the UK and one in the US. One study was designed for individuals with or without dementia.
One other study was explicitly intended for demented older adults and their caregivers. The remaining studies were designed for older adults without cognitive impairment. One study was conducted across residential, hospital, and community settings, whereas three were delivered in a community setting and two in care homes.
The duration and length of ACIs were variable, as some ACIs lasted one to 2 hours with multiple classes available, whereas others were more structured, with sessions lasting 90 minutes over 14 weeks.
Although program provision costs were just like those identified using the HTA framework, the captured advantages were beyond the person. They included stakeholders resembling members of the family, care home personnel, and activity coordinators.
An intensive range of outcomes was captured across HTAs and SROIs, including quality of life, well-being, physical health, community inclusion, social isolation, communication, cognitive function, depression, sadness, loneliness, anxiety, and interest in on a regular basis life. Although the evidence from singing interventions was encouraging, it was inconclusive.
Evidence from one trial suggested that the intervention caused significant improvements in participants’ interest in life and loneliness. Nevertheless, there have been no significant group differences in physical or cognitive outcomes and healthcare costs. All social value analyses reported a positive return on investment.
Participating in arts and creativity programs was generally cost-effective and offered a return on investment. Moreover, ACIs positively impacted physical, social, and psychological health and well-being outcomes. Nonetheless, the limited variety of studies and methodological differences impede conclusively determining which ACIs represent one of the best value for money or are cheaper.
A notable finding from this study is the dearth of evidence on the price, value, and cost-effectiveness of ACIs for improving the health and well-being of older adults. To this end, only six studies were identified despite applying only a number of restrictions. This will likely be as a consequence of limited research into ACIs in older populations or funders not seeing the added value of those evaluations.
This statement may reflect intrinsic biases within the political economy that favor marketable health solutions from which value could be appropriated as profit. Subsequently, ACIs should compete for funding with other interventions, which might require a more robust and extensive evidence base than is currently available.
- Crealey, G., McQuade, L., O’Sullivan, R., & O’Neill, C. (2023). Arts and creativity interventions for improving health and wellbeing in older adults: a scientific literature review of economic evaluation studies. BMC Public Health. doi:10.1186/s12889-023-17369-x