D-CARE: The Dementia Care Study: Design of a Pragmatic Trial of the Effectiveness and Cost Effectiveness of Health System-Based Versus Community-Based Dementia Care Versus Usual Dementia Care.
D-CARE: The Dementia Care Study: Design of a Pragmatic Trial of the Effectiveness and Cost Effectiveness of Health System-Based Versus Community-Based Dementia Care Versus Usual Dementia Care.
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DOI：
10.1111/jgs.16862
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发表时间：
2020-11
影响因子：
6.3
通讯作者：
Peduzzi P
中科院分区：
文献类型：
--
作者：
Reuben DB;Gill TM;Stevens A;Williamson J;Volpi E;Lichtenstein M;Jennings LA;Tan Z;Evertson L;Bass D;Weitzman L;Carnie M;Wilson N;Araujo K;Charpentier P;Meng C;Greene EJ;Dziura J;Liu J;Unger E;Yang M;Currie K;Lenoir KM;Green AS;Abraham S;Vernon A;Samper-Ternent R;Raji M;Hirst RM;Galloway R;Finney GR;Ladd I;Rahm AK;Borek P;Peduzzi P
虽然已经开发了几种方法来为痴呆症患者（PWD）及其家人或朋友的照顾者提供全面的护理，但基于社区与基于卫生系统的痴呆症护理的相对有效性和成本效益以及与常规护理相比这两种方法的有效性尚不清楚。实用随机化3组优效性试验。随机化的单位是PWD/护理者二元组。4个临床试验中心（CTS），位于学术和临床卫生系统。2，150名讲英语或西班牙语的残疾人，他们没有接受临终关怀或居住在养老院，以及他们的照顾者。18个月的1）由在卫生系统内工作的执业护士或医生助理痴呆症护理专家提供的基于卫生系统的痴呆症护理，或2）由在社区组织工作的社会工作者或护士护理顾问提供的基于社区的痴呆症护理，或3）根据需要转介到阿尔茨海默氏症协会帮助热线的患者护理。主要结局：PWD行为症状和照顾者痛苦，通过神经精神问卷（NPI-Q）严重程度和改良照顾者压力指数量表测量。次要结果：NPI-Q痛苦、照顾者未满足的需求和信心以及照顾者抑郁症状。三级结局：PWD长期疗养院安置率，老年人报告的PWD功能状态，认知，目标实现，“在家度过的时间”，痴呆负担量表-照顾者，临床获益的综合指标，痴呆患者的生活质量，照顾的积极方面，以及使用干预费用和医疗保险索赔的成本效益。将于2024年春季报告。D-CARE将解决强调临床支持和与其他医疗服务更紧密结合是否比强调与社区资源更紧密联系的社会支持更有益。它还将评估两种干预措施与常规护理相比的有效性，并将评估每种干预措施的成本效益。
Although several approaches have been developed to provide comprehensive care for persons living with dementia (PWD) and their family or friend caregivers, the relative effectiveness and cost-effectiveness of community-based versus health system-based dementia care and the effectiveness of both approaches compared to usual care are unknown. Pragmatic randomized 3-arm superiority trial. The unit of randomization is the PWD/caregiver dyad. 4 clinical trial sites (CTS) based in academic and clinical health systems. 2,150 English- or Spanish-speaking PWD, who are not receiving hospice or residing in a nursing home, and their caregivers. Eighteen months of 1) Health systems-based dementia care provided by a nurse practitioner or physician’s assistant Dementia Care Specialist who works within the health system, or 2) Community-based dementia care provided by a social worker or nurse Care Consultant who works at a community-based organization, or 3) Usual care with as-needed referral to the Alzheimer’s Association Helpline. Primary outcomes: PWD behavioral symptoms and caregiver distress as measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q) Severity and Modified Caregiver Strain Index scales. Secondary outcomes: NPI-Q Distress, caregiver unmet needs and confidence, and caregiver depressive symptoms. Tertiary outcomes: PWD long-term nursing home placement rates, caregiver-reported PWD functional status, cognition, goal attainment, “time spent at home”, Dementia Burden Scale-Caregiver, a composite measure of clinical benefit, Quality of Life of persons with dementia, Positive Aspects of Caregiving, and cost-effectiveness using intervention costs and Medicare claims. Will be reported in Spring 2024. D-CARE will address whether emphasis on clinical support and tighter integration with other medical services has greater benefit than emphasis on social support that is tied more closely to community resources. It will also assess the effectiveness of both interventions compared to usual care and will evaluate the cost effectiveness of each intervention.
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DOI：
10.1007/s11136-016-1471-7
发表时间：
2017-03
期刊：
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
影响因子：
--
作者：
Jennings LA;Palimaru A;Corona MG;Cagigas XE;Ramirez KD;Zhao T;Hays RD;Wenger NS;Reuben DB
通讯作者：
Reuben DB
蒙特利尔认知评估优于美国国家神经疾病研究所和中风 - 加拿大中风网络5分钟方案，可预测1年的血管认知障碍。
影响因子：
2.6
作者：
Dong Y;Xu J;Chan BP;Seet RC;Venketasubramanian N;Teoh HL;Sharma VK;Chen CL
通讯作者：
Chen CL
影响因子：
14
作者：
通讯作者：
--
DOI：
10.1093/biostatistics/1.4.465
发表时间：
2000-12-01
期刊：
Biostatistics (Oxford, England)
影响因子：
--
作者：
Henderson, R;Diggle, P;Dobson, A
通讯作者：
Dobson, A
影响因子：
6.3
作者：
Peipert JD;Jennings LA;Hays RD;Wenger NS;Keeler E;Reuben DB
通讯作者：
Reuben DB