Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial.

Abstract:

OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a new diagnosis of mild to moderate dementia living in the community and their informal caregivers. INTERVENTIONS:Usual care provided by memory clinic or general practitioner. MAIN OUTCOME MEASURES:Caregiver rated quality of life of the patient measured with the quality of life in Alzheimer's disease instrument and self perceived burden of the informal caregiver measured with the sense of competence questionnaire (intention to treat analysis). RESULTS:The quality of life of the patients in the memory clinic group was 0.5 (95% confidence interval -0.7 to 1.6) points higher than in the general practitioner group. Caregivers' burden was 2.4 (-5.8 to 1.0) points lower in the memory clinic group than in the general practitioner group. CONCLUSION:No evidence was found that memory clinics were more effective than general practitioners with regard to post-diagnosis treatment and coordination care for patients with dementia. Without further evidence on the effectiveness of these modalities, other arguments, such as cost minimisation, patients' preferences, or regional health service planning, can determine which type of dementia care is offered. TRIAL REGISTRATION:Clinical trials NCT00554047.

journal_name

BMJ

authors

Meeuwsen EJ,Melis RJ,Van Der Aa GC,Golüke-Willemse GA,De Leest BJ,Van Raak FH,Schölzel-Dorenbos CJ,Verheijen DC,Verhey FR,Visser MC,Wolfs CA,Adang EM,Olde Rikkert MG

doi

10.1136/bmj.e3086

subject

Has Abstract

pub_date

2012-05-15 00:00:00

pages

e3086

eissn

0959-8138

issn

1756-1833

journal_volume

344

pub_type

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