A controlled trial of Partners in Dementia Care: veteran outcomes after six and twelve months View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-02-28

AUTHORS

David M Bass, Katherine S Judge, A Lynn Snow, Nancy L Wilson, Robert O Morgan, Katie Maslow, Ronda Randazzo, Jennifer A Moye, Germaine L Odenheimer, Elizabeth Archambault, Richard Elbein, Paul Pirraglia, Thomas A Teasdale, Catherine A McCarthy, Wendy J Looman, Mark E Kunik

ABSTRACT

INTRODUCTION: "Partners in Dementia Care" (PDC) tested the effectiveness of a care-coordination program integrating healthcare and community services and supporting veterans with dementia and their caregivers. Delivered via partnerships between Veterans Affairs medical centers and Alzheimer's Association chapters, PDC targeted both patients and caregivers, distinguishing it from many non-pharmacological interventions. Hypotheses posited PDC would improve five veteran self-reported outcomes: 1) unmet need, 2) embarrassment about memory problems, 3) isolation, 4) relationship strain and 5) depression. Greater impact was expected for more impaired veterans. A unique feature was self-reported research data collected from veterans with dementia. METHODS AND FINDINGS: Five matched communities were study sites. Two randomly selected sites received PDC for 12 months; comparison sites received usual care. Three structured telephone interviews were completed every 6 months with veterans who could participate. RESULTS: Of 508 consenting veterans, 333 (65.6%) completed baseline interviews. Among those who completed baseline interviews, 263 (79.0%) completed 6-month follow-ups and 194 (58.3%) completed 12-month follow-ups. Regression analyses showed PDC veterans had significantly less adverse outcomes than those receiving usual care, particularly for more impaired veterans after 6 months, including reduced relationship strain (B = -0.09; p = 0.05), depression (B = -0.10; p = 0.03), and unmet need (B = -0.28; p = 0.02; and B = -0.52; p = 0.08). PDC veterans also had less embarrassment about memory problems (B = -0.24; p = 0.08). At 12 months, more impaired veterans had further reductions in unmet need (B = -0.96; p < 0.01) and embarrassment (B = -0.05; p = 0.02). Limitations included use of matched comparison sites rather than within-site randomization and lack of consideration for variation within the PDC group in amounts and types of assistance provided. CONCLUSIONS: Partnerships between community and health organizations have the potential to meet the dementia-related needs and improve the psychosocial functioning of persons with dementia. TRIAL REGISTRY: NCT00291161. More... »

PAGES

9-9

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/alzrt242

DOI

http://dx.doi.org/10.1186/alzrt242

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1016599558

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24764496


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96 unmet need
97 use
98 usual care
99 variation
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