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[P4–328]: THE EFFICACY OF DEMENTIA CARE MANAGEMENT IN NEWLY DIAGNOSED PEOPLE WITH DEMENTIA: RESULTS OF A CLUSTER‐RANDOMIZED CONTROLLED INTERVENTION TRIAL
Author(s) -
Thyrian Jochen René,
Hertel Johannes,
Hoffmann Wolfgang
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.06.2198
Subject(s) - dementia , intervention (counseling) , medicine , randomized controlled trial , cluster randomised controlled trial , family medicine , physical therapy , psychiatry , disease
Background: Person with dementia (PwD) need interdisciplinary treatment and care. Dementia care management (DCM) approaches, implemented into routine care, can increase quality of treatment and care for dementia. Empirical evidence regardig the benefit of a formal diagnosis in this process is lacking. The objective is: to test the effectiveness of a DCM to improve treatment and care for PwD and their relative caregivers and its association to a formal diagnosis of dementia. Methods:Pragmatic, general-practitioner-based, cluster-randomized intervention trial with baseline and 12-month follow-up and two arms comparing an intervention group with care as usual (DelpHi). Participants:Pn1⁄46,838 people were screened for dementia during routine visits at their treating GP practice and n1⁄41,167 (17%) were eligible (DemTect<9) for the study. A sample of n1⁄4634 gave written informed consent to participate. Intervention(s): DCM is a model of collaborative care and defined as a complex intervention aiming to provide optimum care by integrating multi-professional and multimodal strategies to individualize and optimize treatment and care. Three groups of people screened positive for dementia were analyzed: (a) PWD with a formal diagnosis at screening, (b) having received a formal diagnosis during the study, (c) people without a formal diagnosis at any time. Outcomes: (1) Quality of life, (2) caregiver burden, (3) behavioral and psychological symptoms and (4) pharmacotherapy with an antidementia drugs, and (5) prevention or suspension of PIM after 12 month. Results: Preliminary rsults shwo: Overall, DCM significantly decrease caregiver burden (b1⁄4 -0.50 [95% CI, -1.09 to 0.08], p<0.045) and behavioral and psychological symptoms of dementia (b1⁄4-7.45, [95% CI, -11.08 to 3.81], p<0.001) compared to care as usual. Furthermore, intervention group were significantly more often treated with antidementia drugs (OR: 1.97, [95% CI, 0.99 to 3.94], p<0.028). There were no significant differences between the groups under analysis. Only the use of antidementia drugs was significantly associated with the presence of a formal diagnosis.. Conclusions:DCM is an effective collaborative model of care that can improve patientand caregiver-related outcomes in dementia. It seems that its efficacy is hiin general independent from the presence of a formal diagnosis. Further analyses are neccessary and implications of this fining must be discussed. AMYLOID IMAGING RESULTS TO COGNITIVELY NORMAL OLDER ADULTS: P4-329 ASSESSING THE IMPACT OF DISCLOSING