Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer’s Disease at the Memory Clinic: The BEAT-IT Study

Autor: Eikelboom, Willem S., van den Berg, Esther, Coesmans, Michiel, Goudzwaard, Jeannette A., Koopmanschap, Marc, Lazaar, Najoua, van Bruchem-Visser, Rozemarijn L., Driesen, Jan J. M., den Heijer, Tom, Hoogers, Susanne, de Jong, Frank Jan, Mattace-Raso, Francesco, Thomeer, Elsbeth C., Vrenken, Suzanne, Vroegindeweij, Lilian J. H. M., Zuidema, Sytse U., Singleton, Ellen H., van Swieten, John C., Ossenkoppele, Rik, Papma, Janne M.
Rok vydání: 2023
Předmět:
Zdroj: Eikelboom, W S, van den Berg, E, Coesmans, M, Goudzwaard, J A, Koopmanschap, M, Lazaar, N, van Bruchem-Visser, R L, Driesen, J J M, den Heijer, T, Hoogers, S, de Jong, F J, Mattace-Raso, F, Thomeer, E C, Vrenken, S, Vroegindeweij, L J H M, Zuidema, S U, Singleton, E H, van Swieten, J C, Ossenkoppele, R & Papma, J M 2023, ' Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer's Disease at the Memory Clinic : The BEAT-IT Study ', Journal of Alzheimer's disease : JAD, vol. 93, no. 4, pp. 1407-1423 . https://doi.org/10.3233/JAD-230116
ISSN: 1875-8908
1387-2877
DOI: 10.3233/jad-230116
Popis: Background: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer’s disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented. Objective: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic. Methods: We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden, NPS severity, NPS-related distress, competence managing NPS, and psychotropic drug use. Reliable change index was calculated to identify responders to the intervention. A cost-effectiveness analysis was performed and semi-structured interviews with a subsample of the intervention group (n = 12). Results: The DICE method did not improve any outcomes over time compared to care as usual. Half of the participants of the intervention group (52%) were identified as responders and showed more NPS and NPS-related distress at baseline compared to non-responders. Interviews revealed substantial heterogeneity among participants regarding NPS-related distress, caregiver burden, and availability of social support. The intervention did not lead to significant gains in quality-adjusted life years and well-being years nor clear savings in health care and societal costs. Conclusion: The DICE method showed no benefits at group-level, but individuals with high levels of NPS and NPS-related distress may benefit from this intervention.
Databáze: OpenAIRE
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