Research reveals no distinctions in the effects of dementia care methods on patient behavioral issues or caregiver stress levels.
In a significant development for the healthcare industry, the D-CARE study has been associated with the new Medicare Guiding an Improved Dementia Experience (GUIDE) program. Funded by the Patient-Centered Outcomes Research Institute (PCORI) and the National Institute on Aging (NIA), this comprehensive study was led by investigators at the University of California, Los Angeles, with data management and statistics performed by the Yale Data Coordinating Center.
The study, published in the peer-reviewed Journal of the American Medical Association (JAMA), was conducted at four clinical sites: Atrium Health Wake Forest Baptist, Baylor Scott & White Health, the University of Texas Medical Branch, and Geisinger Health. Participants were randomly assigned to one of three groups: health care system-based care delivered by Dementia Care Specialists, community-based organization-based care delivered by Care Consultants, or usual care.
The D-CARE study is the largest evaluation, to date, of different approaches to providing dementia care. It comprised 2,176 persons with dementia and their caregivers and was conducted from June 2019 to August 2023.
The study's findings highlight the complexities of comparing dementia care models in a real-world setting, particularly during the COVID-19 pandemic. While the effects of the interventions on health care utilization are still pending, the study suggests that while health system and community-based dementia programs may not outperform routine care in reducing caregiver strain or managing patient behaviors, these programs help caregivers navigate the challenges of dementia care more effectively.
One of the key findings of the study is the improvement in caregiver self-efficacy. Caregiver self-efficacy, a measurement of caregivers' confidence in managing dementia-related challenges and accessing support, improved in both the health-system and community-based care approaches and was rated higher than in those receiving usual care. This improvement was observed within 6 months of care delivery and remained consistent throughout the study.
The D-CARE study's additional funding includes support from the Yale Program on Aging/Claude D. Pepper Older Americans Independence Center (P30AG021342), The National Center for Advancing Translational Science (NCATS), The Mexican Health and Aging Study (R01AG018016), The UTMB Claude D. Pepper Older Americans Independence Center (OAIC) (P30 AG024832), The Dewey and Cynthia Robertson Fund for Wake Forest Geriatrics, and the Wake Forest Alzheimer's Disease Research Center (P30 AG049638).
For more information about the D-CARE study and its findings, please visit https://www.dcare-study.org/. If you have any queries regarding the study, you can contact Dr. David Reuben, the principal investigator of the study, who is Archstone Professor of Geriatrics at the David Geffen School of Medicine at UCLA. His email is [email protected].
The D-CARE study's findings have significant implications for healthcare systems, medical groups, community-based organizations, policymakers, and insurers working to improve dementia care. As the population ages and the prevalence of dementia continues to rise, understanding the most effective ways to provide care for those with dementia and their caregivers is of paramount importance. The D-CARE study provides valuable insights into this critical area of healthcare.
