The CAREDEM Case Management Study adapted a promising case management project from the USA (the PREVENT Study) and attempted to test the feasibility and acceptability of this approach to case management for dementia support in English general practice. The research took place in four general practices; two in the north-east of England (Newcastle) one in London and one in Norfolk. It involved provision of support services to community-dwelling people with dementia and their carers.
On a practical level, recruitment of practices and patients into the research project was slow and none of the practices achieved their recruitment target. While stakeholders were positive about the potential of case management only one of the four practices achieved an effective level of case management activity (such as might influence patient and carer outcomes). Case managers’ activity levels were hindered by time constraints, limited clarity about roles, poor integration with other services and low levels of embeddedness within primary care. Participants disagreed about levels of unmet need. Practice nurses had difficulty ring-fencing case management time. Given these problems, it was judged inappropriate to attempt a definitive trial of the model. Different approaches for the evaluation of this type of collaborative working in dementia case management are required.
Iliffe, S. Waugh, A. [and] Poole, M. [et al] (2014). The effectiveness of collaborative care for people with memory problems in primary care: results of the CAREDEM case management modelling and feasibility study. Health Technology Assessment, August 2014, Vol.18(52), pp.1-148. (Click here to view the PubMed abstract).
There is also an Executive Summary.
Case Management for Dementia in Primary Health Care
There is a succinct Canadian systematic review investigating the factors associated with varied results concerning the implementation of case management interventions in primary health care.
Khanassov, V. Vedel, I. Pluye, P. (2014). Case management for dementia in primary health care: a systematic mixed studies review based on the diffusion of innovation model. Clinical Interventions in Aging. June 11th 2014; 9: 915-28.