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The Effect of a Disease Management Intervention on . . . Dementia Care

The effect of a disease management intervention on quality and outcomes of dementia care

Citation Vickery, B., Mittman, B., Connor, K., Pearson, M., Della Penna, R., Ganiats, T., DeMonte, R.,Chodosh, J., Cui, X., Vassar, S., Duan, N. & Lee, M. (2006). The effect of a disease management intervention on quality and outcomes of dementia care. Annals of Internal Medicine, 145(10), 713-726.

Design Randomized, controlled trial

Participants The participants of this study were n=408 patients with dementia age 65 and older paired with n=408 informal caregivers

Outcome / Dependent Variables The effects of the intervention were studied on 23-item list of caregiver and care receiver measures (primary outcomes: assessment, treatment, education and support, and safety). Patient / caregiver health and quality of care were secondary measures.

Procedure 238 dyads were assigned a care manager who conducted a structured home assessment and ongoing follow-up based on need and formal reassessment every 6 months. Care managers collaborated with caregivers to: prioritize problem areas, teach problem-solving skills, initiate care plan actions, an assessment summary, selected recommendations to patient’s primary care physician, and other providers.

Outcomes Participants who received the intervention had higher care quality on 21 of 23 guidelines and higher proportions received community agency assistance than those who received usual care. Patient health-related quality of life, overall quality of patient care, caregiving quality, social support, and level of unmet caregiving assistance needs were better for those in the intervention group than for those in the usual care group. Caregiver health-related quality of life did not differ between the two groups.

Author Vickery, B., Mittman, B., Connor, K., Pearson, M., Della Penna, R., Ganiats, T., DeMonte, R.,Chodosh, J., Cui, X., Vassar, S., Duan, N. & Lee, M.