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Effectiveness of Care Management in Alzheimer Patients

Not Applicable
Completed
Conditions
Alzheimer Disease or Associated Disorder
Mild to Moderately Severe Dementia
Interventions
Other: Intervention of the social worker
Registration Number
NCT01081743
Lead Sponsor
Institut de Sante Publique, d'Epidemiologie et de Developpement
Brief Summary

Context: The French Alzheimer plan 2008-2012 includes the implementation of "disease managers" or social workers, from the onset of the disease, for every patient with a diagnosis of Alzheimer disease or associated disorder. However, previous trials evaluating the efficacy of a systematic intervention for each case from the onset of the disease, including non complex cases, have shown little evidence.

Objective: To evaluate the efficacy of a social worker to prevent behavioural problem for patient with a new diagnosis of Alzheimer disease or associated disorder.

Design and setting: Multicentric cluster randomized control trial. Patients from several memory consultations and specialists (neurologist, psychiatrist or geriatrician) in France are included.

Intervention: In addition to usual care, patients in the intervention group have systematic home visits from a social worker and regular follow-ups by phone over a one-year period. This social worker informs the patient and caregiver, evaluates the needs, gives advices to prevent complications and is a link between the patient and the memory consultation or the specialist. Patient in the control group have absolutely no intervention and are followed-up as usually. In order to not modify the usual care, they have no information on their participation in this trial before the one-year evaluation.

Main outcome measure: NeuroPsychiatric Inventory (NPI) administrated at one year, which evaluates frequency, severity and repercussion of several behavioural problems. Secondary outcomes included disability, cognition, depression, health, quality of life, institutionalization, and resource use.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
270
Inclusion Criteria
  • Clinical diagnosis of Alzheimer's Disease or other dementia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM IV] criteria of dementia)
  • Presence of an informal caregiver
  • Mild to moderately severe dementia (MMSE [10-28])
  • Diagnosis of dementia made by a specialist ≤ 6 months
  • Patient affiliated to the national health insurance system
Exclusion Criteria
  • Institutionalized patient
  • Patient on legal guardianship
  • Behavioural problem with important clinical repercussion
  • Psychotic syndrome
  • Severe and unstable general pathology

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Social workerIntervention of the social worker-
Primary Outcome Measures
NameTimeMethod
NeuroPsychiatric Inventory (NPI)1 year

Evaluation of frequency, severity and repercussion of several behavioural problems

Secondary Outcome Measures
NameTimeMethod
Questionnaire Quality of Life - Alzheimer's Disease (QoL-AD)1 year
Cohen-Mansfield Agitation Inventory (CMAI)1 year
Medical Outcome Study Short Form 36-item health survey (MOS SF-36)1 year
Disablement Assessment for Dementia (DAD)1 year
Montgomery-Asberg Depression Rating Scale (MADRS)1 year
Burden Interview of Zarit1 year
Resource utilization in dementia scale (RUD Lite)1 year
Tiredness scale1 year
Apathy Inventory1 year
Mini Mental State Examination (MMSE)1 year
Global Deterioration Scale (GDS)1 year
Institutionalization1 year

Trial Locations

Locations (1)

ISPED (Institut de Santé Publique, d'Epidémiologie et de Développement)

🇫🇷

Bordeaux, France

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