Introducing case management for people with dementia in primary care: a mixed-methods study

Iliffe, Steve; Robinson, Louise; Bamford, Claire; Waugh, Amy; Fox, Chris; Livingston, Gill; Manthorpe, Jill; Brown, Pat; Stephens, Barbara; Chew‐Graham, Carolyn

doi:10.3399/bjgp14x682333

Cited by 26 publications

(59 citation statements)

References 27 publications

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“…However, the heterogeneity did provide important insights into the different roles of nurses and advances understanding about the intervention itself rather than just its effectiveness. The only clearly de ned role that was examined was that of the primary care based nurse as a care manager [23,[26][27][28]. There were mixed ndings regarding the effectiveness of the nurse-led case management model of care in improving quality of life measures for people living with dementia and their support person(s).…”

Section: Discussionmentioning

confidence: 99%

“…Ollerenshaw et al, [34] suggest that PNs may nd an on-line dementia management support tool useful. Iliffe et al, [26] adapted a US model of primary care based case management (PREVENT) for people with dementia and tested its implementation in UK general practice. Despite case managers, patients and support person(s) reporting a positive experience and perceiving bene ts of case management, Iliffe et al, [26] suggest that case management does not t easily into practice routines and that it was not substantially bene cial for patients and support person(s).…”

Section: Mixed Methods Studiesmentioning

confidence: 99%

“…Four studies [23,[26][27][28] evaluated dementia care management in primary health care. Exploring dementia care knowledge and attitudes of primary health care practitioners was the focus of three studies [3,11,12].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Trickey et al, [11] describe a methodological limitation of using a vignette that may more correctly explore current practice rather than knowledge and attitudes [11]. Iliffe et al, [26] report time constraints for the case management role of the PNs may have meant there was insu cient time to show the potential of case management.…”

Section: Risk Of Biasmentioning

confidence: 99%

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What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

Gibson¹,

Goeman

Pond

2020

Preprint

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Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged and Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published Australian and international literature to identify the existing and potential roles of Practice Nurse’s involvement in the delivery of care to people living with dementia or cognitive impairment and their support person(s) and also describe the characteristics and effectiveness of nurse interventions in dementia models of care in general practice. Methods: We systematically reviewed the evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search identified relevant original research published in English between January 2000 and January 2019 and available in full text. Thirteen articles were included. Results: Characteristics of roles, undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person were identified. These included increased patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions Further research is required to define and evaluate the scope of practice and characteristics of the Practice Nurse role in dementia care provision. Embedding in usual general practice care an evidence-based model of care describing the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic Review registration number PROSPERO 2018 CRD42018088191

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Section: Discussionmentioning

confidence: 99%

Section: Mixed Methods Studiesmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Biasmentioning

confidence: 99%

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What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

Gibson¹,

Goeman

Pond

2020

Preprint

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“…8 Dementia case management (CM) interventions are becoming a central component of primary health care organizations in North America and Europe. [9][10][11][12] According to the …”

mentioning

confidence: 99%

Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

Khanassov

Vedel

2016

Ann Fam Med

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PURPOSE Dementia case management (CM) in primary care is a complex intervention aimed at identifying the various needs of patients with dementia and their caregivers, as well as the organization and coordination of care. A key element of CM is the collaboration of family physicians with case managers. We conducted a systematic mixed-studies review to identify the needs of the patientcaregiver dyad and the effects of CM. METHODSWe searched MEDLINE, PsycINFO, and EMBASE up to October 2014, regardless of the study design. Our main outcomes were needs of patients and their caregivers and the effects of CM on these needs. We used narrative syntheses to develop a taxonomy of needs and to describe the effects of CM on those needs. We used meta-analysis to calculate the prevalence of needs and the standardized mean differences to evaluate the effects of CM on the needs identified.RESULTS Fifty-four studies were included. We identified needs of the patientcaregiver dyad and needs of the patient and caregiver individually. CM addressed the majority of the identified needs. Still, some very common needs (eg, early diagnosis) are overlooked while other needs (eg, education on the disease) are well addressed. Fully establishing the value of CM is difficult given the small number of studies of CM in primary care.CONCLUSIONS There is good evidence that case managers, in collaboration with family physicians, have a pivotal role in addressing the needs of the patientcaregiver dyad. 2016;14:166-177. doi: 10.1370/afm.1898. Ann Fam Med INTRODUCTIONT he proportion of people with dementia is growing dramatically. According to the US Alzheimer's Association, by 2030, 50% of Americans aged 65 years and older will be diagnosed with dementia. 1 In Canada in 2011, 747,000 Canadians lived with cognitive impairment.2 Today, the combined costs are $33 billion per year, 1 and they are projected to increase to $872 billion by 2038. 3,4 Worldwide, dementia is the main contributor to disability-adjusted life years (11.2%), representing a greater burden than cerebral vascular accident (9.5%), heart disease (5.0%), or cancer (2.4%). 5People with dementia need help with challenging changes in behavior, memory, physical disability, and mood. 6 The main source of help is family caregivers, who often suffer from the burdens of caregiving and from depression and health problems. 7 It has been shown that early intervention makes the greatest difference in management of symptoms. 1 The World Health Organization states that it would be challenging to intervene without effective involvement of primary care. 8 Dementia case management (CM) interventions are becoming a central component of primary health care organizations in North America and Europe. [9][10][11][12] According to the 167Case Management Society of America, case management is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communi...

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Effectiveness and Safety of Dementia Care Management in Primary Care

et al. 2017

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Introducing case management for people with dementia in primary care: a mixed-methods study

Cited by 26 publications

References 27 publications

What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

Effectiveness and Safety of Dementia Care Management in Primary Care

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