Premium
Predictors of acceptance of offered care management intervention services in a quality improvement trial for dementia
Author(s) -
Kaisey Marwa,
Mittman Brian,
Pearson Marjorie,
Connor Karen I.,
Chodosh Joshua,
Vassar Stefanie D.,
Nguyen France T.,
Vickrey Barbara G.
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2830
Subject(s) - intervention (counseling) , dementia , randomized controlled trial , health care , multivariate analysis , medicine , dyad , bivariate analysis , psychology , family medicine , nursing , social psychology , statistics , disease , surgery , mathematics , pathology , economics , economic growth
Objective Care management approaches have been proven to improve outcomes for patients with dementia and their family caregivers (dyads). However, acceptance of services in these programs is incomplete, impacting effectiveness. Acceptance may be related to dyad as well as healthcare system characteristics, but knowledge about factors associated with program acceptance is lacking. This study investigates patient, caregiver, and healthcare system characteristics associated with acceptance of offered care management services. Methods This study analyzed data from the intervention arm of a cluster randomized controlled trial of a comprehensive dementia care management intervention. There were 408 patient–caregiver dyads enrolled in the study, of which 238 dyads were randomized to the intervention. Caregiver, patient, and health system factors associated with participation in offered care management services were assessed through bivariate and multivariate regression analyses. Results Out of the 238 dyads, 9 were ineligible for this analysis, leaving data of 229 dyads in this sample. Of these, 185 dyads accepted offered care management services, and 44 dyads did not. Multivariate analyses showed that higher likelihood of acceptance of care management services was uniquely associated with cohabitation of caregiver and patient ( p < 0.001), lesser severity of dementia ( p = 0.03), and higher patient comorbidity ( p = 0.03); it also varied across healthcare organization sites. Conclusions Understanding factors that influence care management participation could result in increased adoption of successful programs to improve quality of care. Using these factors to revise both program design as well as program promotion may also benefit external validity of future quality improvement research trials. Copyright © 2011 John Wiley & Sons, Ltd.