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

杂志文章,多中心研究,随机对照试验
  • Incidence of cervical cancer after several negative smear results by age 50: prospective observational study.

    abstract:OBJECTIVE:To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN:Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry of histopathology and cytopatho...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b1354

    authors: Rebolj M,van Ballegooijen M,Lynge E,Looman C,Essink-Bot ML,Boer R,Habbema D

    更新日期:2009-04-24 00:00:00

  • Inequalities in self rated health in the 1958 birth cohort: lifetime social circumstances or social mobility?

    abstract:OBJECTIVE:To investigate explanations for social inequalities in health with respect to health related social mobility and cumulative socioeconomic circumstances over the first three decades of life. DESIGN:Longitudinal follow up. SETTING:Great Britain. SUBJECTS:Data from the 1958 birth cohort study (all children bo...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7055.449

    authors: Power C,Matthews S,Manor O

    更新日期:1996-08-24 00:00:00

  • Cohort study of hepatotoxicity associated with nimesulide and other non-steroidal anti-inflammatory drugs.

    abstract:OBJECTIVE:To estimate the risk of acute hepatotoxicity associated with nimesulide compared with other non-steroidal anti-inflammatory drugs. DESIGN:Retrospective cohort and nested case-control study. SETTING:Umbria region, Italy. PARTICIPANTS:400 000 current, recent, and past users (almost 2 million prescriptions) o...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.327.7405.18

    authors: Traversa G,Bianchi C,Da Cas R,Abraha I,Menniti-Ippolito F,Venegoni M

    更新日期:2003-07-05 00:00:00

  • The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS?

    abstract:OBJECTIVE:To assess the validity, reliability, and acceptability of the short form 36 (SF 36) health survey questionnaire (a shortened version of a battery of 149 health status questions) as a measure of patient outcome in a broad sample of patients suffering from four common clinical conditions. DESIGN:Postal questio...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6890.1440

    authors: Garratt AM,Ruta DA,Abdalla MI,Buckingham JK,Russell IT

    更新日期:1993-05-29 00:00:00

  • Randomised study of effect of different doses of vitamin A on childhood morbidity and mortality.

    abstract:OBJECTIVES:To determine whether the dose of vitamin A currently recommended by the World Health Organization or half this dose gives better protection against childhood morbidity and mortality. DESIGN:Randomised study. SETTING:A combined oral polio vaccine and vitamin A supplementation campaign in Guinea-Bissau, Afri...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.38670.639340.55

    authors: Benn CS,Martins C,Rodrigues A,Jensen H,Lisse IM,Aaby P

    更新日期:2005-12-17 00:00:00

  • White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review.

    abstract:OBJECTIVES:To summarise evidence on the association between white rice consumption and risk of type 2 diabetes and to quantify the potential dose-response relation. DESIGN:Meta-analysis of prospective cohort studies. DATA SOURCES:Searches of Medline and Embase databases for articles published up to January 2012 using...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.e1454

    authors: Hu EA,Pan A,Malik V,Sun Q

    更新日期:2012-03-15 00:00:00

  • Purpura and dermal thinning associated with high dose inhaled corticosteroids.

    abstract:OBJECTIVE:To assess the effect of high dose inhaled corticosteroids on skin. DESIGN:Cross sectional study of patients receiving treatment for chest diseases. SETTING:Outpatient chest clinic in a teaching hospital. PATIENTS:68 Patients divided into four groups of similar age--namely, 15 receiving long term oral predn...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6739.1548

    authors: Capewell S,Reynolds S,Shuttleworth D,Edwards C,Finlay AY

    更新日期:1990-06-16 00:00:00

  • Effect of reducing total fat intake on body weight: systematic review and meta-analysis of randomised controlled trials and cohort studies.

    abstract:OBJECTIVE:To investigate the relation between total fat intake and body weight in adults and children. DESIGN:Systematic review and meta-analysis of randomised controlled trials and cohort studies. DATA SOURCES:Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials to June 2010. INCLUSION CR...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.e7666

    authors: Hooper L,Abdelhamid A,Moore HJ,Douthwaite W,Skeaff CM,Summerbell CD

    更新日期:2012-12-06 00:00:00

  • Using care bundles to reduce in-hospital mortality: quantitative survey.

    abstract:PROBLEM:To reduce hospital inpatient mortality and thus increase public confidence in the quality of patient care in an urban acute hospital trust after adverse media coverage. DESIGN:Eight care bundles of treatments known to be effective in reducing in-hospital mortality were used in the intervention year; adjusted m...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c1234

    authors: Robb E,Jarman B,Suntharalingam G,Higgens C,Tennant R,Elcock K

    更新日期:2010-03-31 00:00:00

  • Diagnosis and management of subclinical hypothyroidism in pregnancy.

    abstract::In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, prete...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.g4929

    authors: Negro R,Stagnaro-Green A

    更新日期:2014-10-06 00:00:00

  • Oral bisphosphonates and risk of cancer of oesophagus, stomach, and colorectum: case-control analysis within a UK primary care cohort.

    abstract:OBJECTIVE:To examine the hypothesis that risk of oesophageal, but not of gastric or colorectal, cancer is increased in users of oral bisphosphonates. DESIGN:Nested case-control analysis within a primary care cohort of about 6 million people in the UK, with prospectively recorded information on prescribing of bisphosph...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c4444

    authors: Green J,Czanner G,Reeves G,Watson J,Wise L,Beral V

    更新日期:2010-09-01 00:00:00

  • Can contracts drive clinical care?

    abstract::The instrument through which a commissioner purchases health services from a provider is, as in other walks of life, a contract, so considerable importance has been attached by the NHS Executive to the contracting mechanism. A contract should in theory influence the quality of the service provided, but they are in man...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7055.477

    authors: Hopkins A,Solomon JK

    更新日期:1996-08-24 00:00:00

  • Association of echocardiography before major elective non-cardiac surgery with postoperative survival and length of hospital stay: population based cohort study.

    abstract:OBJECTIVE:To determine the association of resting echocardiography before elective intermediate to high risk non-cardiac surgery with survival and length of hospital stay. DESIGN:Population based retrospective cohort study. SETTING:Acute care hospitals in Ontario, Canada, between 1 April 1999 and 31 March 2008. PART...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d3695

    authors: Wijeysundera DN,Beattie WS,Karkouti K,Neuman MD,Austin PC,Laupacis A

    更新日期:2011-06-30 00:00:00

  • Factors influencing recovery from headache after common whiplash.

    abstract:OBJECTIVE:To assess the relation between pretraumatic and trauma related headache in patients suffering from whiplash. DESIGN:Follow up study of patients examined a mean (SD) of 7.4 (4.2) days after trauma and again at three and six months. SETTING:Patients referred from primary care. SUBJECTS:117 patients (mean age...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6905.652

    authors: Radanov BP,Sturzenegger M,Di Stefano G,Schnidrig A,Aljinovic M

    更新日期:1993-09-11 00:00:00

  • Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis.

    abstract:OBJECTIVES:To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences, and costs. DESIGN:Randomised c...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38558.393669.E0

    authors: McManus RJ,Mant J,Roalfe A,Oakes RA,Bryan S,Pattison HM,Hobbs FD

    更新日期:2005-09-03 00:00:00

  • US doctors file lawsuit against antiabortionists.

    abstract::In Oregon, Planned Parenthood and a group of physicians who perform abortions have filed a civil suit against several anti-abortion groups individuals. The suit seeks $200 million in damages and an injunction to bar the defendants from posting information on the Internet that threatens the lives and well-being of the...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 新闻

    doi:10.1136/bmj.318.7178.214a

    authors: Charatan F

    更新日期:1999-01-23 00:00:00

  • Potential impact of missing outcome data on treatment effects in systematic reviews: imputation study.

    abstract:OBJECTIVE:To assess the risk of bias associated with missing outcome data in systematic reviews. DESIGN:Imputation study. SETTING:Systematic reviews. POPULATION:100 systematic reviews that included a group level meta-analysis with a statistically significant effect on a patient important dichotomous efficacy outcome...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.m2898

    authors: Kahale LA,Khamis AM,Diab B,Chang Y,Lopes LC,Agarwal A,Li L,Mustafa RA,Koujanian S,Waziry R,Busse JW,Dakik A,Schünemann HJ,Hooft L,Scholten RJ,Guyatt GH,Akl EA

    更新日期:2020-08-26 00:00:00

  • Female circumcision is curbed in Egypt.

    abstract::In the wake of the death of an 11-year-old girl the Egyptian government has banned any government-affiliated medical staff from performing female circumcision. Egyptian health policy has shifted from trying to control the practice by keeping it under government supervision towards condemnation. In October 1995 the h...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 新闻

    doi:10.1136/bmj.313.7052.249

    authors: Wiens J

    更新日期:1996-08-03 00:00:00

  • Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration.

    abstract:OBJECTIVES:To investigate the effectiveness of non-benzodiazepine hypnotics (Z drugs) and associated placebo responses in adults and to evaluate potential moderators of effectiveness in a dataset used to approve these drugs. DESIGN:Systematic review and meta-analysis. DATA SOURCE:US Food and Drug Administration (FDA)...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.e8343

    authors: Huedo-Medina TB,Kirsch I,Middlemass J,Klonizakis M,Siriwardena AN

    更新日期:2012-12-17 00:00:00

  • Tired, weak, or in need of rest: fatigue among general practice attenders.

    abstract:OBJECTIVES:To determine the prevalence and associations of symptoms of fatigue. DESIGN:Questionnaire survey. SETTING:London general practice. PARTICIPANTS:611 General practice attenders. MAIN OUTCOME MEASURES:Scores on a fatigue questionnaire and reasons given for fatigue. RESULTS:10.2% Of men (17/167) and 10.6% o...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.301.6762.1199

    authors: David A,Pelosi A,McDonald E,Stephens D,Ledger D,Rathbone R,Mann A

    更新日期:1990-11-24 00:00:00

  • Behavioural counselling to increase consumption of fruit and vegetables in low income adults: randomised trial.

    abstract:OBJECTIVE:To measure the effect of brief behavioural counselling in general practice on patients' consumption of fruit and vegetables in adults from a low income population. DESIGN:Parallel group randomised controlled trial. SETTING:Primary health centre in a deprived, ethnically mixed inner city area. PARTICIPANTS:...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.326.7394.855

    authors: Steptoe A,Perkins-Porras L,McKay C,Rink E,Hilton S,Cappuccio FP

    更新日期:2003-04-19 00:00:00

  • Prospective cohort study of retinal vessel diameters and risk of hypertension.

    abstract:OBJECTIVE:To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. DESIGN:Population based prospective cohort study. SETTING:Beaver Dam eye study. PARTICIPANTS:2451 normotensive people aged 43 to 84 years. MAIN OUTCOME MEASURES:Diameters of retinal arterioles and ve...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38124.682523.55

    authors: Wong TY,Shankar A,Klein R,Klein BE,Hubbard LD

    更新日期:2004-07-10 00:00:00

  • Randomised controlled trial of teaching general practitioners to carry out structured assessments of their long term mentally ill patients.

    abstract:OBJECTIVE:To assess the impact of teaching general practitioners to carry out structured assessments of their long term mentally ill patients. DESIGN:Randomised controlled trial. SETTING:Sixteen group general practices in South Thames (west) region. SUBJECTS:440 adults disabled by long term mental illness. INTERVEN...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.311.6997.93

    authors: Kendrick T,Burns T,Freeling P

    更新日期:1995-07-08 00:00:00

  • Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study.

    abstract:OBJECTIVE:To assess the impact of a pay for performance incentive on quality of care and outcomes among UK patients with hypertension in primary care. DESIGN:Interrupted time series. SETTING:The Health Improvement Network (THIN) database, United Kingdom. PARTICIPANTS:470 725 patients with hypertension diagnosed betw...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d108

    authors: Serumaga B,Ross-Degnan D,Avery AJ,Elliott RA,Majumdar SR,Zhang F,Soumerai SB

    更新日期:2011-01-25 00:00:00

  • Cost effectiveness of day and inpatient psychiatric treatment: results of a randomised controlled trial.

    abstract:OBJECTIVE:To compare direct and indirect costs of day and inpatient treatment of acute psychiatric illness. DESIGN:Randomised controlled trial with outcome and costs assessed over 12 months after the date of admission. SETTING:Teaching hospital in an inner city area. SUBJECTS:179 patients with acute psychiatric illn...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.314.7091.1381

    authors: Creed F,Mbaya P,Lancashire S,Tomenson B,Williams B,Holme S

    更新日期:1997-05-10 00:00:00

  • Dietary underreporting by obese individuals--is it specific or non-specific?

    abstract:OBJECTIVE:To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN:Cross sectional. SETTING:Denmark. SUBJECTS:323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE:Bias in dietary reporting of energy and pr...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.7011.986

    authors: Heitmann BL,Lissner L

    更新日期:1995-10-14 00:00:00

  • Association between neuraxial anaesthesia or general anaesthesia for lower limb revascularisation surgery in adults and clinical outcomes: population based comparative effectiveness study.

    abstract:OBJECTIVE:To examine the associations between neuraxial anaesthesia or general anaesthesia and clinical outcomes, length of hospital stay, and readmission in adults undergoing lower limb revascularisation surgery. DESIGN:Comparative effectiveness study using linked, validated, population based databases. SETTING:Onta...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.m4104

    authors: Roberts DJ,Nagpal SK,Kubelik D,Brandys T,Stelfox HT,Lalu MM,Forster AJ,McCartney CJ,McIsaac DI

    更新日期:2020-11-25 00:00:00

  • Congenital anomaly surveillance in England--ascertainment deficiencies in the national system.

    abstract:OBJECTIVE:Firstly, to assess the completeness of ascertainment in the National Congenital Anomaly System (NCAS), the basis for congenital anomaly surveillance in England and Wales, and its variation by defect, geographical area, and socioeconomic deprivation. Secondly, to assess the impact of the lack of data on pregna...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38300.665301.3A

    authors: Boyd PA,Armstrong B,Dolk H,Botting B,Pattenden S,Abramsky L,Rankin J,Vrijheid M,Wellesley D

    更新日期:2005-01-01 00:00:00

  • Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial.

    abstract:OBJECTIVE:To determine the efficacy and safety of the anticoagulant fondaparinux in older acute medical inpatients at moderate to high risk of venous thromboembolism. DESIGN:Double blind randomised placebo controlled trial. SETTING:35 centres in eight countries. PARTICIPANTS:849 medical patients aged 60 or more admi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38733.466748.7C

    authors: Cohen AT,Davidson BL,Gallus AS,Lassen MR,Prins MH,Tomkowski W,Turpie AG,Egberts JF,Lensing AW,ARTEMIS Investigators.

    更新日期:2006-02-11 00:00:00

  • Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia.

    abstract:OBJECTIVE:To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture. DESIGN:Preplanned subanalysis of randomised intervention study. Settting: Jyväskylä Central Hospital, Finland. PARTICIPANTS:243 independently living patients aged 65 years or older admitted to hospital with ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.321.7269.1107

    authors: Huusko TM,Karppi P,Avikainen V,Kautiainen H,Sulkava R

    更新日期:2000-11-04 00:00:00