RoutineDeCM

Background

In Germany, about 1.8 million people are currently living with dementia and the trend is increasing (Blotenberg, Hoffmann & Thyrian, 2023). At the same time, the care of people with dementia (PlwD) presents challenges to healthcare systems worldwide (WHO, 2017). To address these care needs in Germany, the National Dementia Strategy aims to improve the care and support for PlwD and their caregivers. Dementia Care Management is also part of the National Dementia Strategy. The concept is based on the idea of providing care for PlwD while utilizing structures and services that already exist. Three main areas are highlighted:  a) treatment and care management, b) medication management, and c) caregiver support and education (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 primary care physicians in Mecklenburg-Western Pomerania (Thyrian et al., 2016). Now, the transferability of these results to another region in Germany is to be examined.

Project Objective

The aim of RoutineDeCM is to investigate the implementation of Dementia Care Management into the existing healthcare structures of Siegen-Wittgenstein to transfer this concept into the routine care of PlwD in the long term. In doing so, care needs on the nursing, psychosocial, therapeutic, and medical level are to be determined in order to enable PlwD and their caregivers to access offers to healthcare and support services adapted to their individual needs.

Project Procedure

IIn the region of Siegen-Wittgenstein, PlwD and their caregivers 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-assisted methods to assess and coordinate the medical, nursing, psychosocial, and therapeutic care needs of the project participants and facilitate access to healthcare services that meet the individual needs of the participants. Based on this information, the DeCMs will create an individual care plan. The longitudinal study also includes post-assessments and follow-up evaluations six and twelve months after the baseline assessment. This participatory process is accompanied by researchers from the University of Siegen and the DZNE (German Center for Neurodegenerative Diseases), in close cooperation with affected individuals, various providers and stakeholders from different sectors, as well as the system developers. In doing so, the differences between research and routine care in practice will be addressed and adapted to regional conditions. Following this phase, the project will be evaluated and analyzed to ensure the transferability and sustainability of the concept for nationwide implementation into routine care.

References

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).