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The Cost-Effectiveness of Using PARO, a Therapeutic Robotic Seal, to Reduce Agitation and Medication Use in Dementia: Findings from a Cluster-Randomized Controlled Trial
Mervin MC, Moyle W, Jones C, Murfield J, Draper B, Beattie E, Shum DHK, O'Dwyer S et al.. Journal of the American Medical Directors Association, 2018-01-09
Topic: Risk, prevention and care in population studies
Plain-language summary
Objectives To examine the within-trial costs and cost-effectiveness of using PARO, compared with a plush toy and usual care, for reducing agitation and medication use in people with dementia in long-term care. Design An economic evaluation, nested within a cluster-randomized controlled trial. Setting Twenty-eight facilities in South-East Queensland, Australia. Participants A total of 415 residents, all aged 60 years or older, with documented diagnoses of dementia. Intervention Facilities were randomized to 1 of 3 groups: PARO (individual, nonfacilitated 15-minute sessions, 3 afternoons per week for 10 weeks); plush toy (as per PARO but with artificial intelligence disabled); and usual care. Measurements The incremental cost per Cohen-Mansfield Agitation Inventory-Short Form (CMAI-SF) point averted from a provider's perspective. Australian New Zealand Clinical Trials Registry (BLINDED FOR REVIEW). Results For the within-trial costs, the PARO group was $50.47 more expensive per resident compared with usual care, whereas the plush toy group was $37.26 more expensive than usual care. There were no statistically significant between-group differences in agitation levels after the 10-week intervention. The point estimates of the incremental cost-effectiveness ratios were $13.01 for PARO and $12.85 for plush toy per CMAI-SF point averted relative to usual care. Conclusion The plush toy used in this study offered marginally greater value for money than PARO in improving agitation. However, these costs are much lower than values estimated for psychosocial group activities and sensory interventions, suggesting that both a plush toy and the PARO are cost-effective psychosocial treatment options for agitation.
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APA 7th
Mervin, M. C., Moyle, W., Jones, C., Murfield, J., Draper, B., Beattie, E., et al. (2018). The Cost-Effectiveness of Using PARO, a Therapeutic Robotic Seal, to Reduce Agitation and Medication Use in Dementia: Findings from a Cluster-Randomized Controlled Trial. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2017.10.008
Vancouver
Mervin MC, Moyle W, Jones C, Murfield J, Draper B, Beattie E, et al. The Cost-Effectiveness of Using PARO, a Therapeutic Robotic Seal, to Reduce Agitation and Medication Use in Dementia: Findings from a Cluster-Randomized Controlled Trial. Journal of the American Medical Directors Association. 2018. doi:10.1016/j.jamda.2017.10.008. PMID: 29325922.
BibTeX
@article{mervin2018-29325922,
author = {Mervin, M. C. and Moyle, W. and Jones, C. and Murfield, J. and Draper, B. and Beattie, E. and Shum, D. H. K. and O'Dwyer, S. and others},
title = {{The Cost-Effectiveness of Using PARO, a Therapeutic Robotic Seal, to Reduce Agitation and Medication Use in Dementia: Findings from a Cluster-Randomized Controlled Trial}},
journal = {Journal of the American Medical Directors Association},
year = {2018},
doi = {10.1016/j.jamda.2017.10.008},
pmid = {29325922},
url = {https://doi.org/10.1016/j.jamda.2017.10.008}
}
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Key findings
- Objectives To examine the within-trial costs and cost-effectiveness of using PARO, compared with a plush toy and usual care, for reducing agitation and medication use in people with dementia in long-term care.
- Results For the within-trial costs, the PARO group was $50.47 more expensive per resident compared with usual care, whereas the plush toy group was $37.26 more expensive than usual care.
- There were no statistically significant between-group differences in agitation levels after the 10-week intervention.
- However, these costs are much lower than values estimated for psychosocial group activities and sensory interventions, suggesting that both a plush toy and the PARO are cost-effective psychosocial treatment options for agitation.
Why it matters
This randomized controlled trial found no statistically significant between-group differences in agitation levels after using PARO, a plush toy, or usual care. PARO was $50.47 more expensive per resident than usual care, so it did not show a significant benefit for reducing agitation.
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Study details
- Study designrandomized controlled trial
- Participants415
- Evidence strengthHigh
How this study scored 69/100
Published in a peer-reviewed journal, and it is a randomized controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Medical Directors Association) |
| Journal's citation record | 2 / 4 | Journal of the American Medical Directors Association: journal h-index 172 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomized controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 415 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 2 / 2 | Randomized and blinded or placebo-controlled (as stated in the record) |
| Times cited | 5 / 7 | Cited 106 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.6 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 5 / 6 | Cited 23.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 27 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Lukman Thalib: h-index 55 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Chinese Academy of Sciences: institution h-index 1,801 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29325922) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 69 / 100 | — |
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