Interest of Systematic Tracking of Dementia Cases in Nursing Homes: Analysing the Contribution of MultiDisciplinary Team Meeting (MDTM) in Alzheimer's Disease and Related Diseases
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,428
- 试验地点
- 90
- 主要终点
- Incidence of hospitalizations in emergency care units
研究概览
简要总结
Introduction: Epidemiological data show that in France only half of patients with Alzheimer disease are currently diagnosed in the general population. The absence of early diagnosis of dementia reduces the opportunities of patients to receive optimal care. One of the consequences of undiagnosed dementia is inadequate use of emergency care units.
The main objective: The main aim of this study is to evaluate the impact of a systematic case-finding procedure of dementia cases in nursing homes through a MDTM on the rate of hospitalization in emergency care units.
Secondary objectives:
To assess the impact of systematic tracking of dementia cases on the:
- Quantity and quality of drug-prescription
- Appropriateness of hospitalizations
- Prevalence of neuropsychiatric symptoms
- Dependency
- Quality of life
- Burden of nursing staff working conditions
- Planning of specific therapeutic measures
- Overall health care costs
详细描述
This is a multicentre, cluster randomized study comparing two parallel groups:
- Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project
- Control group: nursing homes whose residents continue to benefit from usual care In each group, 1000 elderly subjects aged over 60 years without documented diagnosis of dementia will be included and monitored for a period of 18 months.
Information about the main and secondary aims will be collected monthly through online questionnaires.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Residents of both sex, aged 60 years or over
- •Residents living in a nursing home participating in the study
- •Residents living in the nursing home for 30 days or more
- •Residents without diagnosed and documented dementia, identified as follows:
- •residents not identified by the French Healthcare system as suffering from dementia (ALD 15)
- •residents not benefiting from a specific care program or a specialized follow-up for dementia
- •residents for whom there is no appropriate investigation for dementia diagnosis in medical records
- •residents not taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
- •Residents and their GP having received information about the study
- •Residents and their GP having expressed their agreement to participate in the study
排除标准
- •Residents aged less than 60 years
- •Residents not living in a nursing home participating in study
- •Residents living in nursing home for less than 30 days
- •Residents with diagnosed and documented dementia, identified as follows:
- •residents Identified by the French Healthcare system as suffering from dementia (ALD 15)
- •residents benefiting from specific care programme or specialized follow-up for dementia
- •residents for whom there is appropriate investigation for dementia diagnosis in medical records
- •residents taking specific drugs for dementia (Cholinesterase inhibitors and/or Memantine)
- •Residents and/or their GP who received no information about the study
- •Residents and/or their GP having expressed their opposition to participate in the study
研究组 & 干预措施
Intervention group
Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project
干预措施: MultiDisciplinary Team Meetings (MDTM) (Other)
control group
Control group: nursing homes whose residents continue to benefit from usual care
结局指标
主要结局
Incidence of hospitalizations in emergency care units
时间窗: 18 months
Monthly collection during follow-up (18 months)
次要结局
- Prevalence of antipsychotic prescription(Baseline visit, 4 months, 18 months)
- Incidence of inappropriate hospitalizations(18 months)
- Prevalence of neuropsychiatric symptoms evaluated by NPI-nursing staff version(Baseline visit, 18 months)
- Dependency evaluated by AGGIR and IADL-4 items(Baseline visit, 18 months)
- Quality of life evaluated by QOL-AD(Baseline visit, 18 months)
- Number of nursing staff's time off work(18 months)
- Number of days off work by nursing staff(18 months)
- Presence of advanced care planning in patients medical records(Baseline visit, 18 months)
- Overall healthcare costs(18 months)