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Patients from the physician network who received collaborative dementia care management had more pronounced clinically relevant neuropsychiatric symptoms and the highest number of unmet needs but limited access to social and nursing care services. |
Despite their direct access to professional nursing care, patients in day care centers also had many identified unmet needs, particularly for medical care, underlining the need in both settings. |
Patients who received collaborative dementia care management as an additional healthcare service in the physician network achieved a higher quality of life at lower costs than those who received the intervention in day care centers, supporting the more significant benefit of implementation in physician-based settings. |
Introduction
The increasing prevalence of persons living with dementia (PwD) and the associated economic burden challenge healthcare systems globally. Current estimations assume the number of PwD will rise to 153 million worldwide by 2050, while the costs could increase to US$2 trillion by the end of the current decade [1, 2–3]. The latest figures for Germany indicate a forecasted increase from 1.8 million PwD in 2021 to 3.0 million by 2070 [4, 5].
General practitioners (GPs) have been the initial contact persons on the patient's journey. They are responsible for early diagnosis necessary for access to dementia-specific postdiagnostic treatment. However, previous studies already addressed the underdiagnosing of dementia in primary care and its consequences, demonstrating that only 30% and 36% of PwD received recommended and evidence-based dementia-specific medication with antidementia drugs and non-drug treatments, respectively [6, 7, 8, 9–10]. Additionally, studies revealed that almost all PwD and caregivers show unmet healthcare needs, which are, in turn, associated with poor health outcomes [11]. Several countries introduced strategies and guidelines to improve timely diagnosis and post-diagnostic support e.g., the German government developed a National Dementia Strategy (NDS), underlining dementia as a health priority [12, 13].
The German NDS aims to improve the support for PwD and their relatives by implementing collaborative dementia care management (cDCM) into routine care to overcome the challenges of timely formal diagnosis with guideline-related post-diagnostic support, treatment, and care [12]. This development was accompanied by adoption of cDCM into the nation’s S-3 (i.e., highest methodological quality for elaborated consensual recommendations) guidelines for dementia [14]. cDCM is a nonpharmacological intervention provided...