Trial Outcomes & Findings for Intervention Study to Improve Life and Care for People With Dementia and Their Caregivers in Primary Care (NCT NCT01401582)

NCT ID: NCT01401582

Last Updated: 2025-08-20

Results Overview

The Quality of Life in Alzheimer's Disease (Qol-AD; Logsdon et al. 2002) was used. This measure designed specifically to obtain a rating of the patient's quality of life from both the patient and the caregiver. Each item is rated on a four point scale, with 1 being poor and 4 being excellent. Total scores, obtained by the sum of all 13 items, range from 13 to 52.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

634 participants

Primary outcome timeframe

one year after baseline assessment

Results posted on

2025-08-20

Participant Flow

1/1/2012-12/31/2014 Screening in participating General practices (GP)

Participant milestones

Participant milestones
Measure
Care as Usual
care as usual, no intervention, just observation of natural change/ trajectories over time
Implementation of Dementia Care Manager
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Provision of a "Dementia Care Manager": Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers.
Overall Study
STARTED
226
408
Overall Study
Baseline Completed
168
348
Overall Study
COMPLETED
116
291
Overall Study
NOT COMPLETED
110
117

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Intervention Study to Improve Life and Care for People With Dementia and Their Caregivers in Primary Care

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Care as Usual
n=168 Participants
care as usual, no intervention, just observation of natural change/ trajectories over time published in Thyrian et al. (2016). Journal of Alzheimer´s Disease (52); 69-617.
Implementation of Dementia Care Manager
n=348 Participants
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Provision of a "Dementia Care Manager": Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers. published in Thyrian et al. (2016). Journal of Alzheimer´s Disease (52); 69-617.
Total
n=516 Participants
Total of all reporting groups
Age, Continuous
79.6 years
STANDARD_DEVIATION 5.3 • n=5 Participants
80.2 years
STANDARD_DEVIATION 5.7 • n=7 Participants
80.0 years
STANDARD_DEVIATION 5.5 • n=5 Participants
Sex: Female, Male
Female
96 Participants
n=5 Participants
211 Participants
n=7 Participants
307 Participants
n=5 Participants
Sex: Female, Male
Male
72 Participants
n=5 Participants
137 Participants
n=7 Participants
209 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
168 Participants
n=5 Participants
348 Participants
n=7 Participants
516 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: one year after baseline assessment

The Quality of Life in Alzheimer's Disease (Qol-AD; Logsdon et al. 2002) was used. This measure designed specifically to obtain a rating of the patient's quality of life from both the patient and the caregiver. Each item is rated on a four point scale, with 1 being poor and 4 being excellent. Total scores, obtained by the sum of all 13 items, range from 13 to 52.

Outcome measures

Outcome measures
Measure
Care as Usual
n=116 Participants
care as usual, no intervention, just observation of natural change/ trajectories over time
Implementation of Dementia Care Manager
n=291 Participants
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Implementation of Dementia Care Manager: Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers.
Change in Quality of Life
2.8 units on a scale
Standard Deviation 0.3
2.8 units on a scale
Standard Deviation 0.4

PRIMARY outcome

Timeframe: one year after baseline assessment

Caregiver burden was assessed using the "Berliner Inventar zur Angehörigenbelastung - Demenz" (BIZA-D) (Zank et al., 2006). The BIZAD was developed to assess objective as well as subjective burden due to caring for a person wit dementia (PWD). It consists of 88 items covering 20 dimensions of caregiver burden. Objective burden is divided into six dimensions: 1) basic care tasks like support eating, hygiene etc (7 items), 2) extended care tasks like supporting grocery shopping, legal affairs etc. (3 items), 3) Motivation and Guidance (4 items), 4) emotional support (4 items), 5) supporting maintenance of social contacts (3 items) and 6) supervision (4 items). Each item has to be rated regarding the frequency of the support needed on a 5-Point scale (example: supervision; Does the patient need this kind of support: 1=always, 2= mostly, 3=partly, 4=hardly, 5= not at all). Then each item asks: Who is providing this support: all by someone else, mostly by someone else, evenly distributed

Outcome measures

Outcome measures
Measure
Care as Usual
n=116 Participants
care as usual, no intervention, just observation of natural change/ trajectories over time
Implementation of Dementia Care Manager
n=291 Participants
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Implementation of Dementia Care Manager: Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers.
Change in Caregiver Burden
0.4 units on a scale
Standard Deviation 2.62
0.13 units on a scale
Standard Deviation 2.63

PRIMARY outcome

Timeframe: one year after baseline assessment

Neuropsychiatric Inventory (NPI; Cummings 1997); The NPI represents an interview by proxy on twelve dimensions of neuropsychiatric behaviors, i.e. delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and appetite and eating abnormalities. The presence (0= no, 1= yes) is asked. If present, the severity (rated 1 through 3; mild to severe) and frequency (1 to 4, rarely to very often) of each neuropsychiatric symptom are rated on. Thus the score for each dimension ranges from 0 = not present, 1= mildly and rarely to 12 = severe and often. A total NPI score is calculated as the sum of the frequency by severity scores ofeach domain range: 0 to 144, the higher the more neuropsychiatric symptomatic).

Outcome measures

Outcome measures
Measure
Care as Usual
n=116 Participants
care as usual, no intervention, just observation of natural change/ trajectories over time
Implementation of Dementia Care Manager
n=291 Participants
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Implementation of Dementia Care Manager: Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers.
Change in Behavioral and Psychological Symptoms of Dementia
15.2 units on a scale
Standard Deviation 16.9
8.2 units on a scale
Standard Deviation 13.6

PRIMARY outcome

Timeframe: one year after baseline assessment

medication was systematically reviewed; A computer-based home medication review (HMR) encompasses all medications used by the study participants and includes questions about compliance, adverse effects and drug administration. The collection of primary data on medication in the context of the HMR includes both prescription drugs and over-the-counter drugs. The assignment was then integrated using a master file of the Pharmaceutical Index. The following antidementia drugs were considered: donepezil (N06AD02), rivastigmine (N06AD03), galantamine (N06AD04) and memantine (N06AX01).

Outcome measures

Outcome measures
Measure
Care as Usual
n=116 Participants
care as usual, no intervention, just observation of natural change/ trajectories over time
Implementation of Dementia Care Manager
n=291 Participants
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Implementation of Dementia Care Manager: Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers.
Change in Medical Treatment With Antidementia Drugs
31 participants
114 participants

PRIMARY outcome

Timeframe: one year after baseline assessment

Having to deal with multimorbidity and polypharmacy in a sample of chronically ill elderly, we also analyze potentially inappropriate medication (PIM), defined as "a drug for which the risk of an adverse event outweighs the clinical benefit, particularly when there is evidence in favor of a safer or more effective alternative therapy for the same condition". The PIM were identified using the Priscus list, which contains 83 drugs from 18 different drug classes.

Outcome measures

Outcome measures
Measure
Care as Usual
n=116 Participants
care as usual, no intervention, just observation of natural change/ trajectories over time
Implementation of Dementia Care Manager
n=291 Participants
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Implementation of Dementia Care Manager: Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers.
Reduction of Potential Inapropriate Medication (PIM)
19 Participants
77 Participants

SECONDARY outcome

Timeframe: one year after baseline assessment

The functional status was assessed using the Bayer Activities of Daily Living Scale (B-ADL). It coonsits of 25 Items indicating everyday problems/ challenges. Their occurence is rated on a scale of 1 "never", to 10 "always". All ratings are added and divided by the number of items. This yields a mean score of 1 to 10, where 1 indicates the lowest possible impairment and 10 indicates the highest possible impairment.

Outcome measures

Outcome measures
Measure
Care as Usual
n=116 Participants
care as usual, no intervention, just observation of natural change/ trajectories over time
Implementation of Dementia Care Manager
n=291 Participants
Subjects in this arm will be provided with a specialised "Dementia Care Manager" to be included in a subsidiary support system Implementation of Dementia Care Manager: Home-visits of trained "Dementia Care Manager (DCM)" at least monthly for 6 months. The DCM will, in close cooperation with the general practitioner, establish and include a subsidiary support system for subjects and their caregivers.
Person With Dementia: Change in Activities of Daily Living
4.4 units on a scale
Standard Deviation 2.4
4.9 units on a scale
Standard Deviation 2.9

SECONDARY outcome

Timeframe: participants will be followed yearly until institutionalisation or death after an expected average of 5 years

The F-SozU (Fydrich et al. 2007) will be used to assess social support in several domains

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: participants will be followed yearly until institutionalisation or death after an expected average of 5 years

Several instruments will be used to assess the health of the person with dementia: the GP records the Fragebogen zum SF12- health survey (SF-12, Bullinger et al. 1998) the standardized assessment of elderly in primary care (STEP; Sandholzer et al. 2004) the Brief Symptom Inventory (BSI; Derogatis et al. 1983) the Patient´s health questionnaire (PHQ-D; Löwe et al. 2002, Spitzer et al. 1999)

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: participants will be followed yearly until institutionalisation or death after an expected average of 5 years

frequency of utilisation of 1. general physicians and physicians of other specialties 2. out-patient treatments 3. in-patient treatments 4. hospitalisations 5. institutionalisation 6. therapeutic appliances standardised assessment with the Resource Utilization in Dementia (RUD, Wimo et al. 1998).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: participants will be followed yearly until institutionalisation or death after an expected average of 5 years

The DCM will conduct an IT-supported home medication review (Fiss et al., 2010) at the patients home with subsequent medication management by the local pharmacy regarding frequency of drug related problems, intake of PIM, clinically relevant drug-drug interaction, adherence, utilisation of adherence supporting activities (medication plan, drug dispenser, support by care service, reduction of the number of drugs taken

Outcome measures

Outcome data not reported

Adverse Events

Care as Usual

Serious events: 0 serious events
Other events: 0 other events
Deaths: 19 deaths

Implementation of Dementia Care Manager

Serious events: 0 serious events
Other events: 0 other events
Deaths: 35 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

PD Dr. JR Thyrian

Geman Centr for Neurodegenerative Diseases (DZN)

Phone: +49383486

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place