CMHTs provide follow-up for patients with dementia and behavioural and psychological symptoms of dementia in both service models

Rubinsztein, Judy S.; Girling, Deborah M.; Brayne, Carol

doi:10.1192/pb.39.4.205a

Cited by 2 publications

(4 citation statements)

References 2 publications

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“…Our preliminary data are consistent with previous reports suggesting that MU are an alternative for dementia care. Although the evidence is still scarce ( 33 ), most studies show that MU deliver benefits for patients ( 61 ), caregivers ( 62 ), clinicians and health systems ( 63 ) with better outcomes than treatment as usual ( 25 ). However, as mentioned above, the data available on cost-effectiveness of MU is contradictory ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

“…MU consist of multidisciplinary teams, bringing together professionals such as neurologists, geriatricians, psychiatrists, psychologists, neuropsychologists, occupational therapists, speech therapists, and nurses ( 24 ). MU have been proposed as a more comprehensive service at no extra cost compared to traditional community mental health teams ( 25 ); however, there is still a dearth of data supporting the cost-effectiveness of MU as part of the dementia care system ( 26 ). Therefore, more research is needed regarding the analysis of the health economic aspects and the implementation of MU.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating a Memory Clinic Using the RE-AIM Model. The Experience of the “Memory and Neuropsychiatry Clinic” in Hospital Del Salvador, Chile

et al. 2021

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The development of healthcare services for dementia is key to improving access to care and post-diagnostic support for people living with dementia. Memory Units have emerged as a new healthcare service composed of multidisciplinary teams with the goal of improving diagnosis and/or management of dementia patients. The main objective of this study was to describe and evaluate the Reach and Effectiveness of a Memory Unit in a public hospital in Chile, using the RE-AIM model, a multi-component model that allows for the evaluation of the implementation of ongoing healthcare programs. Regarding “R” (Reach): from March 2018 up to June 2019, a total of 510 patients were referred and assessed. Most patients came from primary care (51.9%) and from outpatient services at the Hospital Salvador (39.2%), particularly from the Neurology (63.3%) and Psychiatry (16.0%) departments. We estimated that our Memory Unit assessed 5.39% of all of the dementia patients living in the area of referral. With respect to “E” (Effectiveness): 419 patients are still being followed up at the Memory Unit. Ninety-one patients (18%) were discharged. Of these, 55 (66%) were referred to primary healthcare, 28 (31%) to other outpatient services, 9 (10%) to a specialized mental healthcare center, and 9 (10%) to a daycare center. Due to the short period of time that the Memory Unit has been operating, no other RE-AIM dimensions could be evaluated at this juncture. To our knowledge, this is the first implementation study of a Memory Unit in Latin America, and the first using the RE-AIM model. Although cultural differences worldwide might play a role in the lack of international guidelines, the publication of the experience of the first year of this unit in Chile could inform new countries about this process. Ongoing challenges include continuing to collect data to complement the RE-AIM evaluation and developing a protocol that can be adopted elsewhere in Chile and Latin America. Further studies are needed to assess the benefits of a Memory Unit in comparison to regular care and to develop a model that assures continuity and coordination of care for people with dementia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating a Memory Clinic Using the RE-AIM Model. The Experience of the “Memory and Neuropsychiatry Clinic” in Hospital Del Salvador, Chile

et al. 2021

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“…5 Primary care, and most hospital clinics are simply not able to provide this. In response, 'Memory Clinics' were developed in the USA 40 years ago and, since then, various cognitive clinic models have been developed around the world, providing a comprehensive service at no extra cost 6 and better satisfaction with care. 7 Similar to most other countries, in Australia, there is considerable variation in pathways to a diagnosis, and there are insufficient Memory Clinics to meet demand.…”

Section: Introductionmentioning

confidence: 99%

“…Primary care, and most hospital clinics are simply not able to provide this. In response, ‘Memory Clinics’ were developed in the USA 40 years ago and, since then, various cognitive clinic models have been developed around the world, providing a comprehensive service at no extra cost 6 and better satisfaction with care 7 …”

Section: Introductionmentioning

confidence: 99%

A new one‐stop interdisciplinary cognitive clinic model tackles rural health inequality and halves the time to diagnosis: Benchmarked against a national dementia registry

Alty,

Lawler,

Salmon

et al. 2023

Int J Geriat Psychiatry

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ObjectivesUnequal access to cognitive assessments is a major barrier to timely diagnosis, especially for those living in rural or remote areas. ‘One‐stop’ cognitive clinic models are a proposed solution, but few such clinics exist. We evaluate the implementation of a new one‐stop State‐wide clinic model in Tasmania, Australia, where 27% of people live in rural/remote areas.MethodsA novel single‐visit protocol has been developed, comprising interdisciplinary medical and cognitive assessments, research participation, consensus diagnosis and management plan. A cross‐sectional evaluation was undertaken using the RE‐AIM (reach, effectiveness, adoption, implementation, maintenance) framework and results benchmarked against the national Australian Dementia Network Registry.ResultsOver the first 52 consecutive weekly clinics: Reach: 130 adults were assessed (mean age [SD] 70.12 years [10.31]; 59.2% female) with 40 (36.8%) from rural/remote areas. Effectiveness: 98.5% (128/130) received a same‐day diagnosis: 30.1% (n = 40) Subjective Cognitive Decline, 35.4% (46) Mild Cognitive Impairment, 33.1% (43) dementia and one case inconclusive. Adoption: 22.9% (156) of General Practitioners referred patients. Implementation: Nearly all ‘ideal’ diagnostic clinical practices were met and >90% of surveyed patients reported ‘good/very good’ clinic experience. The wait from referral to diagnosis was 2 months shorter than other national Registry clinics (78 vs. 133 days).ConclusionsThis ‘one‐stop’ model provides an interdisciplinary consensus cognitive diagnosis quickly and is well accepted; this may reduce health inequities especially for people living in rural/remote areas. This cognitive clinic model may be of relevance to other centres worldwide and also provides a rich data source for research studies.

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CMHTs provide follow-up for patients with dementia and behavioural and psychological symptoms of dementia in both service models

Cited by 2 publications

References 2 publications

Evaluating a Memory Clinic Using the RE-AIM Model. The Experience of the “Memory and Neuropsychiatry Clinic” in Hospital Del Salvador, Chile

Evaluating a Memory Clinic Using the RE-AIM Model. The Experience of the “Memory and Neuropsychiatry Clinic” in Hospital Del Salvador, Chile

A new one‐stop interdisciplinary cognitive clinic model tackles rural health inequality and halves the time to diagnosis: Benchmarked against a national dementia registry

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