Author: Vickrey B G, Mittman B S, Connor K I, Pearson M L, Della Penna R D, Ganiats T G, De Monte Jr R W, Chodosh J, Cui X, Vassar S, Duan N and Lee M
Journal: Annals of Internal Medicine, 2006
Volume/pages: Vol 145(10), pp713-726

About the study
This American randomized controlled trial (RCT) explored whether an integrated disease management programme (DMP) in dementia care affected the extent to which guidelines were followed. A steering committee involving senior individuals from health and social care organizations developed integrated care coordination and referral protocols. This large study included 408 older people (aged 65 years and over) with dementia and 408 informal carers. Adherence to guidelines was a used as a proxy measure for quality of care, and was determined through a survey of carers and a review of patients’ medical records.

Findings
Adherence to the guideline recommendations was higher in the group that took part in the intervention, with 63.9% of care following guidelines in comparison to only 32.9% in the control group. The survey showed that patients who received the intervention experienced a number of other positive outcomes including better health-related quality of life than the group receiving usual care.

Key messages

• Integrated approaches are particularly relevant in areas like dementia care where patients have both health and social care needs
• A coordinated approach including joint planning and protocols is an effective way of achieving better adherence to care guidelines and improved outcomes for patients