gms | German Medical Science

Background: Aging of the population is expected to cause a rapid increase in the prevalence of people with dementia (PWD). According to estimates, prevalence is expected to double every 20 years. Thus, dementia diseases are a healthcare priority. Since causal treatment is still out of sight, there is a need for more efficient ways of management and care. There is a lack of evidence-based models of healthcare provision PWD in primary care. The objective of the presentation is to present the outcomes of the DelpHi-trial regarding (1) its efficacy and on health- and dementia related outcomes for PWD in primary care, as well as to demonstrate the (2) effect on healthcare cost.

Methods: DelpHi is a general physician (GP)-based, cluster-randomized, controlled intervention trial with two arms. Written informed consent was obtained from n=634 patients. Whereas control group received “care as usual”, the intervention arm received “Dementia Care Management (DCM)” that consists of (a) a comprehensive assessment of the care situation, needs and resources, (b) a computer-assisted development of an individually tailored treatment and care plan (c) a systematic and documented communication with treating GP, (d) support in and monitoring of achieving treatment and care goals. DCM is provided by specifically trained nurses. At baseline and follow-up (one year) sociodemographic and clinical variables were assessed. The primary outcomes of the intervention are quality of life, neuropsychiatric symptoms, treatment with antidementia drugs, potential inadequate medication (PIM) and caregiver burden. Health economic analyses were conducted from societal perspective.

Results: We will present changes in variables and outcome from baseline to follow-up, differences between control and intervention group regarding primary outcomes and healthcare costs and will describe variables associated with changes and outcomes.