DOC-PG: integrated multidisciplinary assessment and Usual care: assessment by GP or one of the regional services in Memory Disorders and Delirium, Dementia, Amnestic, Cognitive Disorders - Clinical Trials Registry

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

An integrated multidisciplinary approach to diagnosing and managing dementia is generally recommended, though rarely investigated. In recent years, multidisciplinary memory clinics (MCs) for patients with dementia have been established in many places over the world. These services have recently also been criticised for being principally hospital-based, for their apparently limited focus that entails only medical diagnostics and pharmacotherapy and for thus diverting resources from community mental health teams(CMHTs) .On the other hand, CMHTs are mainly concerned with the provision and organisation of integrated care, and unlike MCs, CMHTs generally have limited access to hospital-based diagnostics such as brain-imaging.

In April 2002, an outpatient diagnostic facility, the Diagnostic Observation Centre for PsychoGeriatric patients (DOC-PG) was established in Maastricht, the Netherlands. DOC-PG combines the hospital-based approach of the MC with the care-oriented approach of the regional CMHT and aims to provide the general practitioner (GP) with elaborate diagnostic and therapeutic advice for patients with cognitive disorders.

Comparison: DOC-PG is compared with usual care i.e. the GP took care of the diagnosis, or he or she referred the patient to one of the separate regional services, e.g. the Maastricht Memory Clinic (MMC), geriatric medicine, or the department of mental health for the elderly of the mental health community service (CMHT).

Study Type

Interventional

Enrollment

216

Phase

Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Netherlands
- Limburg
  - Maastricht, Limburg, Netherlands, 6202 AZ
    - Academic Hospital Maastricht

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

55 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Aged 55 years or over
Suspected of having dementia or combined somatic/psychiatric disorder
No referral to other local/regional services in the last two years
Availability of a proxy (visiting the patient at least once a week)

Exclusion Criteria:

Acute disorders that need a prompt therapeutic intervention
Living in a nursing home or receiving care that is comparable to that of a nursing home

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Interventional Model: Parallel Assignment
Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
The Visual Analogue Scale of the EuroQol-5D

Secondary Outcome Measures

Outcome Measure
Mini Mental State Examination (MMSE)
Utility score of the EuroQol-5D
Short Form 36 (SF-36)
Global Deterioration Scale (GDS)
NeuroPsychiatric Inventory (NPI)
Instrumental Activities of Daily Living scale (IADL)
Cornell Scale of Depression in Dementia (CSDD)
Perceived Pressure from Informal Care (Dutch translation, EDIZ)
Informal care questionnaire

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Maastricht University Medical Center

Collaborators

ZonMw: The Netherlands Organisation for Health Research and Development

Investigators

Principal Investigator: Frans R Verhey, PhD, MD, Maastricht University Medical Center
Study Director: Carmen D. Dirksen, PhD, Maastricht University Medical Center
Study Director: Johan L Severens, PhD, Maastricht University Medical Center
Study Chair: Alfons Kessels, MD, MSc, Maastricht University Medical Center
Study Chair: Claire A Wolfs, MSc, Maastricht University Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Wolfs CA, Dirksen CD, Severens JL, Verhey FR. The added value of a multidisciplinary approach in diagnosing dementia: a review. Int J Geriatr Psychiatry. 2006 Mar;21(3):223-32. doi: 10.1002/gps.1454.
Wolfs CAG, Severens JL, Dirksen CD, Kessels A, Jaspers N, Verhey FRJ. 2005. A Randomized Clinical Trial on the Effects of a Diagnostic Observation Centre for PsychoGeriatric patients (DOC-PG). International Psychogeriatrics 17: 370-371
Wolfs CA, Verhey FR, Kessels A, Winkens RA, Severens JL, Dirksen CD. GP concordance with advice for treatment following a multidisciplinary psychogeriatric assessment. Int J Geriatr Psychiatry. 2007 Mar;22(3):233-40. doi: 10.1002/gps.1666.
Wolfs CA, Dirksen CD, Kessels A, Severens JL, Verhey FR. Economic evaluation of an integrated diagnostic approach for psychogeriatric patients: results of a randomized controlled trial. Arch Gen Psychiatry. 2009 Mar;66(3):313-23. doi: 10.1001/archgenpsychiatry.2008.544.

Helpful Links

Related Info

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2002

Study Completion

August 1, 2005

Study Registration Dates

First Submitted

November 20, 2006

First Submitted That Met QC Criteria