Introduction: Epidemiological data show that in France only half of patients with Alzheimer disease are currently diagnosed in the general population. The absence of early diagnosis of dementia reduces the opportunities of patients to receive optimal care. One of the consequences of undiagnosed dementia is inadequate use of emergency care units. The main objective: The main aim of this study is to evaluate the impact of a systematic case-finding procedure of dementia cases in nursing homes through a MDTM on the rate of hospitalization in emergency care units. Secondary objectives: To assess the impact of systematic tracking of dementia cases on the: * Quantity and quality of drug-prescription * Appropriateness of hospitalizations * Prevalence of neuropsychiatric symptoms * Dependency * Quality of life * Burden of nursing staff working conditions * Planning of specific therapeutic measures * Overall health care costs
This is a multicentre, cluster randomized study comparing two parallel groups: * Intervention group: nursing homes whose residents benefit from MDTM to identify the cases of dementia and to propose an adequate care project * Control group: nursing homes whose residents continue to benefit from usual care In each group, 1000 elderly subjects aged over 60 years without documented diagnosis of dementia will be included and monitored for a period of 18 months. Information about the main and secondary aims will be collected monthly through online questionnaires.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
1,428
The MDTM, between the memory experts and Nursing Home coordinating practitioners, could help the nursing home medical staff identify the cases of dementia and propose these residents an adequate healthcare project (supplementary investigations, therapeutic modifications, hospitalizations...)
Centre de Gerontologie Pompeyrie Chu Agen
Agen, France
Ehpad Maison de Retraite Louise Anceau
Albi, France
Ehpad Maison de Retraite Olga Ducoudray
Albi, France
Ehpad Mr "Les Jardins de Jouvence"
Albi, France
Mapad La Renaudie Ch Albi
Albi, France
Ehpad Les Ajoncs D'Or
Incidence of hospitalizations in emergency care units
Monthly collection during follow-up (18 months)
Time frame: 18 months
Prevalence of antipsychotic prescription
Time frame: Baseline visit, 4 months, 18 months
Incidence of inappropriate hospitalizations
Monthly collection during follow-up (18 months)
Time frame: 18 months
Prevalence of neuropsychiatric symptoms evaluated by NPI-nursing staff version
Time frame: Baseline visit, 18 months
Dependency evaluated by AGGIR and IADL-4 items
Time frame: Baseline visit, 18 months
Quality of life evaluated by QOL-AD
Time frame: Baseline visit, 18 months
Number of nursing staff's time off work
Monthly collection during follow-up (18 months)
Time frame: 18 months
Number of days off work by nursing staff
Monthly collection during follow-up (18 months)
Time frame: 18 months
Presence of advanced care planning in patients medical records
Advanced care planning will be checked through behavioural disosders, transfer to hospital intensive care and resuscitation
Time frame: Baseline visit, 18 months
Overall healthcare costs
Monthly collection during follow-up (18 months)
Time frame: 18 months
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Allaire, France
Ehpad Maison de Retraite Hl Ax Les Thermes
Ax-les-Thermes, France
Ehpad Marie Lehman
Balma, France
Ehpad Kerdigemer
Brest, France
Ehpad Residence Ker-Heol
Brest, France
...and 80 more locations