1. A model of dementia care management implemented through telephone and internet was shown to be more effective in improving health outcomes in patients with dementia, mood, and caregiver burden compared to standard care alone.
Evidence Rating Level: 1 (Excellent)
The use of dementia care management programs for patients with dementia (PWD) and their caregivers can improve health outcomes when combined with current standards of care. The implementation of these programs for collaborative dementia care, however, is not widespread. In this single-blind, randomized clinical trial, 780 PWD-caregiver dyads were randomized to receive care through the Care Ecosystem, a program for collaborative dementia care delivered over the telephone and internet (n=512), or usual care (n=268) to study whether this intervention is effective in improving outcomes important to PWDs and caregivers. All PWD participants were formally diagnosed with dementia, spoke English, Spanish, or Cantonese, and were enrolled or eligible for Medicaid or Medicare. Primary outcomes included 13 components of PWD well-being as reported by their caregivers (e.g., physical health, mood, memory, finances); secondary outcomes included hospitalizations, caregiver depression and burden ratings, and ambulance use. Approximately 84% of the dyads were active at 12-month follow-up and 73% completed the 12-month survey. Investigators found that, compared to standard care, the Care Ecosystem group demonstrated reduced emergency department use (p=0.04), increased PWD quality of life (p=0.04), decreased caregiver burden (p=0.046), and reduced caregiver depression (p=0.03). This study therefore shows that quality of life in PWD as well as the well-being of their caregivers can be improved through the implementation of telemedicine and educational approaches in combination with standard dementia care.
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