Evaluating the Effectiveness of a New Way of Organizing Primary Health Care to Improve the Management of Alzheimer's Disease

Study Overview
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Brief Summary
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The objective of the present study is to evaluate the effectiveness of a general practitioner (MG) management strategy guided by a multidimensional evaluation on the multidimensional score of fragility of patients with mild to moderately severe dementia, compared to those currently implemented (without the provision of such an assessment). The measurement of the respective effectiveness of the two types of care in primary care will itself be based on a multidimensional evaluation performed independently in the memory center having established the diagnosis of Alzheimer's disease. The secondary objectives are the evaluation of the impact of the strategy on the functional abilities of patients, the incidence of geriatric syndromes, cognitive functions, quality of life of the patient and the burden of the primary caregiver. The efficiency of the strategy will be assessed through a cost-effectiveness analysis. A survey of opinions will also be conducted among primary health care providers, carers and CMs on the implemented system.

Official Title
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Evaluating the Effectiveness of a New Way of Organizing Primary Health Care to Improve the Management of Alzheimer's Disease EvaMMADom

Conditions
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Alzheimer's Disease

Intervention / Treatment
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* Other: Multidimensional fragility index questionnaire RAI-Home Care
* Other: Usual care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with probable Alzheimer's disease, according to the criteria usually used in memory centers Aged over 64 years with mild to moderately severe dementia syndrome Volunteers for medical follow-up for a period of 20 months; Which the general practitioner attending agrees to participate in the research Exclusion Criteria: Patients under 65 years old presenting with early cognitive decline or severe dementia Not meeting the clinical diagnostic criteria for Alzheimer's disease Refusing or unable to sign informed consent to participate Not voluntary for medical follow-up for a period of 20 months Whose general practitioner refuses to participate in the research

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: the multidimensional score of fragility (RAI CA)<br>A general practitioner (MG) management strategy guided by a multidimensional evaluation (RAI-CA) on the multidimensional score of fragility (RAI-HC) of patients with mild to moderately severe dementia. | Other: Multidimensional fragility index questionnaire RAI-Home Care<br>* Questionnaire for assessing deficits in Alzheimer's disease<br>|
| Placebo Comparator: Usual care<br>support for patients without multidimensional evaluation (RAI-CA) | Other: Usual care<br>* Usual clinical evaluation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of multidimensional fragility scores | The multidimensional evaluation score produced by Nurses in the home of AM patients and passed on to patients' doctors increases decision-making and patient care | 20 months |