Abid Iraqi, MD
Potential Financial Conflicts of Interest: None disclosed.
Iraqi A.; Disease Management Intervention on Quality and Outcomes of Dementia Care. Ann Intern Med. 2007;147:69. doi: 10.7326/0003-4819-147-1-200707030-00014
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Published: Ann Intern Med. 2007;147(1):69.
TO THE EDITOR:
Vickrey and colleagues (1) highlight the substantial difference in care managers' adherence to dementia guideline–based disease management. In the study, the care managers were social workers. However, the authors did not mention how the physicians may have played a role in the difference.
As the authors outline, providers in the intervention group had better knowledge of how to assess the patients' decision-making capacity and had a greater perception of the difficulty of dementia care management than did those in the usual care group. These physicians may have adhered more to the guidelines of dementia management than did their counterparts in the usual care group. Furthermore, these physicians may have provided more education to the caregivers about the natural course of dementia and about what to anticipate and how to handle issues that may arise. They may have also encouraged and made early referral to the community agency, resulting in higher utilization of services from community agencies and utilization of such services as respite and day care. Improvement in caregiver outcome may also be related to higher social support in the intervention group than in the usual care group. Patients cared for by usual care group providers had higher mean dementia severity scores and mean duration of symptoms of dementia—both of which may adversely affect caregiver stress and outcome.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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