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Randomized Controlled Trial
. 2012 May 15:344:e3086.
doi: 10.1136/bmj.e3086.

Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial

Els J Meeuwsen  1 , René J F Melis, Geert C H M Van Der Aa, Gertie A M Golüke-Willemse, Benoit J M De Leest, Frank H J M Van Raak, Carla J M Schölzel-Dorenbos, Desiree C M Verheijen, Frans R J Verhey, Marieke C Visser, Claire A Wolfs, Eddy M M Adang, Marcel G M Olde Rikkert
Affiliations
Randomized Controlled Trial

Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial

Els J Meeuwsen et al. BMJ. .

Abstract

Objective: To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners.

Design: Multicentre randomised controlled trial.

Setting: Nine memory clinics and 159 general practitioners in the Netherlands.

Participants: 175 patients with a new diagnosis of mild to moderate dementia living in the community and their informal caregivers.

Interventions: Usual care provided by memory clinic or general practitioner.

Main outcome measures: Caregiver rated quality of life of the patient measured with the quality of life in Alzheimer's disease instrument and self perceived burden of the informal caregiver measured with the sense of competence questionnaire (intention to treat analysis).

Results: The quality of life of the patients in the memory clinic group was 0.5 (95% confidence interval -0.7 to 1.6) points higher than in the general practitioner group. Caregivers' burden was 2.4 (-5.8 to 1.0) points lower in the memory clinic group than in the general practitioner group.

Conclusion: No evidence was found that memory clinics were more effective than general practitioners with regard to post-diagnosis treatment and coordination care for patients with dementia. Without further evidence on the effectiveness of these modalities, other arguments, such as cost minimisation, patients' preferences, or regional health service planning, can determine which type of dementia care is offered.

Trial registration: Clinical trials NCT00554047.

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Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

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Flow diagram of study
See this image and copyright information in PMC

Comment in

References

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    1. Passmore AP, Craig DA. The future of memory clinics. Psychiatric Bulletin 2004;28:375-7.

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