Cost-effectiveness of post-diagnosis treatment in dementia coordinated by multidisciplinary memory clinics in comparison to treatment coordinated by general practitioners: An example of a pragmatic trial

Meeuwsen, E.J.; German, Pearl S.; Melis, René J. F.; Adang, Eddy; Golüke-Willemse, Gertie; Krabbe, Paul F M; Leest, B. J. de; Raak, F.H. van; Schölzel-Dorenbos, C.J.M.; Visser, Marieke C.; Wolfs, Claire; Vliek, S.B.; Rikkert, Marcel G M Olde

doi:10.1007/s12603-009-0066-1

Cited by 33 publications

(26 citation statements)

References 43 publications

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“…The participants in the present study were 145 pairs, consisting of community-dwelling persons with dementia and their informal caregivers, drawn from the AD-Euro RCT (a costeffectiveness study on postdiagnosis care in dementia) [18]. The present study includes patients with a newly diagnosed dementia fulfilling Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision; DSM-IV-TR) criteria and a score of 0.5e2 on the clinical dementia rating (CDR; 0e3) scale: 0 for none; 0.5 for questionable/very mild; 1 for mild; 2 for moderate; and 3 for severe dementia [19,20].…”

Section: Respondentsmentioning

confidence: 99%

Thurstone scaling revealed systematic health-state valuation differences between patients with dementia and proxies

Arons

Krabbe

Schölzel-Dorenbos

et al. 2012

Journal of Clinical Epidemiology

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Section: Respondentsmentioning

confidence: 99%

Thurstone scaling revealed systematic health-state valuation differences between patients with dementia and proxies

Arons

Krabbe

Schölzel-Dorenbos

et al. 2012

Journal of Clinical Epidemiology

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“…Different types of physicians, with various training backgrounds, working in a range of clinical settings, provide diagnostic and treatment services in varying degrees of coordination with each other and with non-medical service providers. In particular, considerable controversy exists regarding the specific roles that should be played by generalists and specialists in the diagnosis and management of AD, and how such medical care could best be organised and integrated with public health, mental health and psychosocial service providers (2,5).…”

Section: Introductionmentioning

confidence: 99%

Clinical practice patterns of generalists and specialists in Alzheimer's disease: What are the differences, and what difference do they make?

Robinson

Vellas

Knox

et al. 2010

The Journal of nutrition, health and aging

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Optimising the roles played by both generalists and specialists in the diagnosis and treatment of Alzheimer's disease (AD) could have a major impact on the quality and cost of patient care. Therefore, one aim of the IMPACT survey was to characterise the similarities and differences between these 2 categories of physicians, in 5 different European countries, across a number of domains relevant to the medical care of people at risk for AD and those with the disease. Physician respondents comprised 250 generalists and 250 specialists from 5 European countries--France, Germany, Italy, Spain, and the United Kingdom. A substantial majority of generalists were either general practitioners or family physicians; the majority of specialists were neurologists. In April and May 2009, physician respondents completed a 30-minute, Web-based questionnaire during which they were presented with a number of multiple-choice-type questions concerning their knowledge of AD, approach to diagnosis and treatment of AD and experience of providing care for people with dementia. Generalists reported that 45% of their AD patients had mild symptoms at the initial visit compared with 60% for specialists (P < 0.001). Specialists claimed that they diagnose patients with AD themselves in 65% of cases versus 33% for generalists (P < 0.001). The main prescription treatment options employed were AD-specific medication (90%) and medication for mood or behaviour (78%). A similar percentage of generalists and specialists (77% and 75%) initiate drug treatment within 1 month of diagnosis. Overall, there were more similarities than differences between specialists and generalists regarding a broad spectrum of issues relating to AD; differences between countries appear to be greater than differences between physician groups.

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“…HRQoL questionnaires enable patient's clustering according to their most frequent health concerns, ranking its intensity [1,11]. Also, HRQoL assessment can be considered a stimulating approach for effectiveness and the cost-effectiveness promotion (survival and quality-adjusted survival) contributing thus to the construction of an economical decision model [12-14]. …”

Section: Introductionmentioning

confidence: 99%

Patient reported outcomes in head and neck cancer: selecting instruments for quality of life integration in clinical protocols

et al. 2010

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BackgroundHealth Related Quality of Life has been used in medical research for more than twenty years, being progressively accepted during the last decade as an important patient reported outcome. Considering the multidimensional approach involved in Health Related Quality of Life assessment, instrument applicability and cultural adaptation must be tested for each population. In order to select the most appropriate instrument for Head and Neck cancer patients, two major Health Related Quality of Life specific questionnaires for Head and Neck cancer patients were compared. Conceptual differences, psychometric characteristics, scores, reliability, construct validity and sensitivity to symptomatology, tumour location, tumour size were analyzed.Methods102 consecutive Head and Neck cancer patients completed two different Health Related Quality of Life questionnaires: EORTC QLQ-C30 and its specific head and neck module QLQ-H&N35 and the Functional Assessment of Cancer Therapy Scales (FACT-H&N). Patients completed the questionnaires, immediately before consultation as a part of the routine evaluation.ResultsA greater variability was always found in the EORTC QLC-C30 questionnaire's scores for all comparable domains. Both instruments revealed a good internal consistency and demonstrated to be good tools to distinguish symptomatic patients. The EORTC questionnaires still demonstrated sensitivity to distinguish T3 and T4 staging. Conceptual differences and the psychometric characteristics are discussed. Our results suggest that these two instruments assess different aspects of Health Related Quality of Life - the questionnaires should be used separately and chosen according to the study objectives and methodology.ConclusionsThis study emphases the importance in selecting the appropriate tool as a critical success factor in implementing routine Health Related Quality of Life assessment in clinical practice. This decision assumes particularly importance when utilization of results in real time and integration into clinical protocols are considered.

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Cost-effectiveness of post-diagnosis treatment in dementia coordinated by multidisciplinary memory clinics in comparison to treatment coordinated by general practitioners: An example of a pragmatic trial

Abstract: ClinicalTrials.gov Identifier NCT00554047.

Cited by 33 publications

References 43 publications

Thurstone scaling revealed systematic health-state valuation differences between patients with dementia and proxies

Thurstone scaling revealed systematic health-state valuation differences between patients with dementia and proxies

Clinical practice patterns of generalists and specialists in Alzheimer's disease: What are the differences, and what difference do they make?

Patient reported outcomes in head and neck cancer: selecting instruments for quality of life integration in clinical protocols

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