Background

There are currently around 1.8 million people living with dementia in Germany and the trend is increasing (Blotenberg, Hoffmann & Thyrian, 2023). At the same time, the care of people with dementia (PwD) poses challenges for the healthcare system worldwide (WHO, 2017). In order to address these care needs in Germany, the National Dementia Strategy aims to improve the care and support of PwD and their relatives and friends. Dementia Care Management is also part of the National Dementia Strategy. The concept of Dementia Care Management is based on enabling the care of PwD while using the structures and services that already exist. Three main areas are highlighted here: a) treatment and care management, b) medication management and c) support and knowledge transfer for relatives (Eichler et al., 2013). Previous studies have already demonstrated the effectiveness, efficiency and safety (Thyrian et al., 2017; Michalowsky et al., 2019) as well as the acceptance of dementia care management by general practitioners in primary care in Mecklenburg-Western Pomerania (Thyrian et al., 2016). The transferability of the results to another region of Germany is now to be examined.

Aim of the project

The aim of RoutineDeCM is to investigate the implementation of dementia care management in the existing care structures in Siegen-Wittgenstein in order to transfer DeCM into the routine care of people with dementia in the long term. The aim is to determine care needs at the nursing, psychosocial, therapeutic and medical levels in order to enable people with dementia and their relatives and friends to access services from the health and care system that are adapted to their individual needs.

Project schedule

In the Siegen-Wittgenstein region, people with dementia and their relatives will be recruited from July 2022 to September 2023 to be supported and accompanied for six months by specifically qualified professionals, the Dementia Care Managers (DeCMs). During this period, the DeCMs will use computer support to collect and coordinate the medical, nursing, psychosocial and therapeutic care needs of the project participants and facilitate access to care services that meet the individual needs of the test subjects. On this basis, the DeCMs will create an individual care plan in cooperation with all those involved. The longitudinal study also provides for post- and follow-up surveys six and twelve months after the baseline survey. This participatory process will be accompanied by researchers from the University of Siegen and the DZNE, in close cooperation with those affected, various providers and payers from different areas, and the developers of the system. The aim is to eliminate the differences between research and routine care in practice and to adapt them to regional conditions. Following the implementation phase, the project will be evaluated and analyzed to ensure the transferability and sustainability of the concept for nationwide implementation in routine care.

Bibliography

1. Blotenberg, I., Hoffmann, W. & Thyrian, J. R. (2023). Dementia in Germany: Epidemiology and prevention potential. Deutsches Arzteblatt International. doi.org/10.3238/arztebl.m2023.0100
2. Eichler, T., Thyrian, J. R., Dreier, A., Wucherer, D., Köhler, L., Fiss, T., Böwing, G., Michalowsky, B. & Hoffmann, W. (2013). Dementia care management: Going new ways in ambulant dementia care within a GP-based randomized controlled intervention trial. International Psychogeriatrics, 26(2), 247–256. doi.org/10.1017/s1041610213001786
3. Mental Health and Substance Use. (2017). Global Action Plan on the Public Health Response to Dementia 2017–2025. www.who.int. www.who.int/publications/i/item/9789241513487
4. Michalowsky, B., Xie, F., Eichler, T., Hertel, J., Kaczynski, A., Kilimann, I., Teipel, S. J., Wucherer, D., Zwingmann, I., Thyrian, J. R. & Hoffmann, W. (2019). Cost-effectiveness of a collaborative dementia care management-Results of a cluster-randomized controlled trial. Alzheimers & Dementia, 15(10), 1296–1308. doi.org/10.1016/j.jalz.2019.05.008
5. Thyrian, J. R., Eichler, T., Pooch, A., Albuerne, K., Dreier, A., Michalowsky, B., Wucherer, D. & Hoffmann, W. (2016). Systematic, early identification of dementia and dementia care management are highly appreciated by general physicians in primary care – results within a cluster-randomized-controlled trial (DELPHI). Journal of multidisciplinary healthcare, 183. doi.org/10.2147/jmdh.s96055
6. Thyrian, J. R., Hertel, J., Wucherer, D., Eichler, T., Michalowsky, B., Dreier-Wolfgramm, A., Zwingmann, I., Kilimann, I., Teipel, S. J. & Hoffmann, W. (2017). Effectiveness and safety of dementia care management in primary care. JAMA Psychiatry, 74(10), 996. https://doi.org/10.1001/jamapsychiatry.2017.2124
7. World Health Organization. Global Action Plan on the Public Health Response to Dementia 2017–2025; World Health Organization: Geneva, Switzerland, 2017; Available online: www.who.int/publications/i/item/9789241513487 (accessed on 10 March 2022).