[IDA project--concept and implementation of a cluster-randomized trial on dementia management in a general practice setting]

Abstract

Given the multiple deficits in dementia care IDA is a health services research project that addresses the key role of general practitioners in the early detection of dementia, patient and family education, therapy and referral to further counseling and supportive measures. Mid 2005 IDA was started by the AOK Bavaria as a pilot project targeting patients living at home. This three-armed cluster-randomized trial--currently including 180 participating general practitioners--is to compare two supportive measures of different intensity (counseling for care-giving relatives and care management) with the usual care in terms of time to nursing home placement. Additional outcomes investigated include the development of the patient's cognitive status and his abilities to perform activities of daily living, burden and quality of life of care-giving relatives as well as healthcare costs and costs of institutional care. Participating patients with initially mild to moderate disease will be observed for a period of two years. Data collection will proceed via general practitioners and caregivers and also utilize routine data of statutory health insurances and long-term care insurances. Keeping in mind that patient recruitment is ongoing throughout 2006 the initial analysis of 254 patients' data shows an average 80-year old patient in the early phase of moderate dementia. One third of the participants are cases with a first- time diagnosis obtained from their general practitioner. Final results for IDA are expected to be available in 2009.