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Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study)
Objective To test the effectiveness of a comprehensive specific care plan in decreasing the rate of functional decline in patients with mild to moderate Alzheimer’s disease compared with usual care in memory clinics. Design Cluster randomised trial. Setting 50 memory clinics in France. Participants...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BMJ Publishing Group Ltd.
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881198/ https://www.ncbi.nlm.nih.gov/pubmed/20522656 http://dx.doi.org/10.1136/bmj.c2466 |
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author | Nourhashemi, Fati Andrieu, Sandrine Gillette-Guyonnet, Sophie Giraudeau, Bruno Cantet, Christelle Coley, Nicola Vellas, Bruno |
author_facet | Nourhashemi, Fati Andrieu, Sandrine Gillette-Guyonnet, Sophie Giraudeau, Bruno Cantet, Christelle Coley, Nicola Vellas, Bruno |
author_sort | Nourhashemi, Fati |
collection | PubMed |
description | Objective To test the effectiveness of a comprehensive specific care plan in decreasing the rate of functional decline in patients with mild to moderate Alzheimer’s disease compared with usual care in memory clinics. Design Cluster randomised trial. Setting 50 memory clinics in France. Participants Patients with Alzheimer’s disease (mini-mental state examination score 12-26). 1131 patients were included: 574 from 26 clinics in the intervention group, and 557 from 24 clinics in the usual care (control) group. Memory clinics were the unit of randomisation. Intervention The intervention included a comprehensive standardised twice yearly consultation for patients and their caregivers, with standardised guidelines for the management of problems identified during the assessment. Main outcome measures The primary outcome measure was change on the Alzheimer’s Disease Cooperative Study-activities of daily living scale assessed at 12 and 24 months. Secondary outcome measures were the rate of admission to institutional care and mortality. Results At two years the assessment was completed by 58.4% (n=335) of patients in the intervention group and 61.6% (n=343) in the control group. The rate of functional decline at two years did not differ between the groups. The annual rate of change on the Alzheimer’s Disease Cooperative Study-activities of daily living was estimated at −5.73 (95% confidence interval −6.89 to −4.57) in the intervention group and −5.96 (−7.05 to −4.86) in the control group (P=0.78). Conclusion A comprehensive specific care plan in memory clinics had no additional positive effect on functional decline in patients with mild to moderate Alzheimer’s disease. Future research should aim to determine the effects of more direct involvement of general practitioners. Trial registration ClinicalTrials.gov NCT00480220. |
format | Text |
id | pubmed-2881198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-28811982010-06-09 Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study) Nourhashemi, Fati Andrieu, Sandrine Gillette-Guyonnet, Sophie Giraudeau, Bruno Cantet, Christelle Coley, Nicola Vellas, Bruno BMJ Research Objective To test the effectiveness of a comprehensive specific care plan in decreasing the rate of functional decline in patients with mild to moderate Alzheimer’s disease compared with usual care in memory clinics. Design Cluster randomised trial. Setting 50 memory clinics in France. Participants Patients with Alzheimer’s disease (mini-mental state examination score 12-26). 1131 patients were included: 574 from 26 clinics in the intervention group, and 557 from 24 clinics in the usual care (control) group. Memory clinics were the unit of randomisation. Intervention The intervention included a comprehensive standardised twice yearly consultation for patients and their caregivers, with standardised guidelines for the management of problems identified during the assessment. Main outcome measures The primary outcome measure was change on the Alzheimer’s Disease Cooperative Study-activities of daily living scale assessed at 12 and 24 months. Secondary outcome measures were the rate of admission to institutional care and mortality. Results At two years the assessment was completed by 58.4% (n=335) of patients in the intervention group and 61.6% (n=343) in the control group. The rate of functional decline at two years did not differ between the groups. The annual rate of change on the Alzheimer’s Disease Cooperative Study-activities of daily living was estimated at −5.73 (95% confidence interval −6.89 to −4.57) in the intervention group and −5.96 (−7.05 to −4.86) in the control group (P=0.78). Conclusion A comprehensive specific care plan in memory clinics had no additional positive effect on functional decline in patients with mild to moderate Alzheimer’s disease. Future research should aim to determine the effects of more direct involvement of general practitioners. Trial registration ClinicalTrials.gov NCT00480220. BMJ Publishing Group Ltd. 2010-06-03 /pmc/articles/PMC2881198/ /pubmed/20522656 http://dx.doi.org/10.1136/bmj.c2466 Text en © Nourhashemi et al 2010 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. |
spellingShingle | Research Nourhashemi, Fati Andrieu, Sandrine Gillette-Guyonnet, Sophie Giraudeau, Bruno Cantet, Christelle Coley, Nicola Vellas, Bruno Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study) |
title | Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study) |
title_full | Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study) |
title_fullStr | Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study) |
title_full_unstemmed | Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study) |
title_short | Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study) |
title_sort | effectiveness of a specific care plan in patients with alzheimer’s disease: cluster randomised trial (plasa study) |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881198/ https://www.ncbi.nlm.nih.gov/pubmed/20522656 http://dx.doi.org/10.1136/bmj.c2466 |
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