Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer's Disease at the Memory Clinic : The BEAT-IT Study
(2023) In Journal of Alzheimer's Disease 93(4). p.1407-1423- Abstract
Background: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer's disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented. Objective: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic. Methods: We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden,... (More)
Background: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer's disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented. Objective: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic. Methods: We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden, NPS severity, NPS-related distress, competence managing NPS, and psychotropic drug use. Reliable change index was calculated to identify responders to the intervention. A cost-effectiveness analysis was performed and semi-structured interviews with a subsample of the intervention group (n = 12). Results: The DICE method did not improve any outcomes over time compared to care as usual. Half of the participants of the intervention group (52%) were identified as responders and showed more NPS and NPS-related distress at baseline compared to non-responders. Interviews revealed substantial heterogeneity among participants regarding NPS-related distress, caregiver burden, and availability of social support. The intervention did not lead to significant gains in quality-adjusted life years and well-being years nor clear savings in health care and societal costs. Conclusion: The DICE method showed no benefits at group-level, but individuals with high levels of NPS and NPS-related distress may benefit from this intervention.
(Less)
- author
- organization
- publishing date
- 2023-06-13
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Alzheimer's disease, apathy, behavioral and psychological symptoms of dementia, delivery of care, dementia, depression, neuropsychiatric inventory, neuropsychiatric symptoms
- in
- Journal of Alzheimer's Disease
- volume
- 93
- issue
- 4
- pages
- 17 pages
- publisher
- IOS Press
- external identifiers
-
- pmid:37182887
- scopus:85163920080
- ISSN
- 1387-2877
- DOI
- 10.3233/JAD-230116
- language
- English
- LU publication?
- yes
- id
- 704415e5-bbd2-4fcf-9768-93cc5679a8be
- date added to LUP
- 2023-11-07 10:41:53
- date last changed
- 2024-04-19 03:45:20
@article{704415e5-bbd2-4fcf-9768-93cc5679a8be,
abstract = {{<p>Background: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer's disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented. Objective: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic. Methods: We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden, NPS severity, NPS-related distress, competence managing NPS, and psychotropic drug use. Reliable change index was calculated to identify responders to the intervention. A cost-effectiveness analysis was performed and semi-structured interviews with a subsample of the intervention group (n = 12). Results: The DICE method did not improve any outcomes over time compared to care as usual. Half of the participants of the intervention group (52%) were identified as responders and showed more NPS and NPS-related distress at baseline compared to non-responders. Interviews revealed substantial heterogeneity among participants regarding NPS-related distress, caregiver burden, and availability of social support. The intervention did not lead to significant gains in quality-adjusted life years and well-being years nor clear savings in health care and societal costs. Conclusion: The DICE method showed no benefits at group-level, but individuals with high levels of NPS and NPS-related distress may benefit from this intervention.</p>}},
author = {{Eikelboom, Willem S. and Van Den Berg, Esther and Coesmans, Michiel and Goudzwaard, Jeannette A. and Koopmanschap, Marc and Lazaar, Najoua and Van Bruchem-Visser, Rozemarijn L. and Driesen, Jan J.M. and Den Heijer, Tom and Hoogers, Susanne and De Jong, Frank Jan and Mattace-Raso, Francesco U. S. and Thomeer, Elsbeth C. and Vrenken, Suzanne and Vroegindeweij, Lilian J.H.M. and Zuidema, Sytse U. and Singleton, Ellen H. and Van Swieten, John C. and Ossenkoppele, Rik and Papma, Janne M.}},
issn = {{1387-2877}},
keywords = {{Alzheimer's disease; apathy; behavioral and psychological symptoms of dementia; delivery of care; dementia; depression; neuropsychiatric inventory; neuropsychiatric symptoms}},
language = {{eng}},
month = {{06}},
number = {{4}},
pages = {{1407--1423}},
publisher = {{IOS Press}},
series = {{Journal of Alzheimer's Disease}},
title = {{Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer's Disease at the Memory Clinic : The BEAT-IT Study}},
url = {{http://dx.doi.org/10.3233/JAD-230116}},
doi = {{10.3233/JAD-230116}},
volume = {{93}},
year = {{2023}},
}