title: (Cost)-effectiveness of case-management by district nurses among primary informal caregivers of older adults with dementia symptoms and the older adults who receive informal care: design of a randomized controlled trial [ISCRTN83135728].
abstract: BACKGROUND
  Dementia is an incurable disease with devastating consequences for both patients and their relatives. The objective of this study is to describe the study protocol of a randomized controlled trial with assignment to either usual care or case-management by district nurses, among informal caregivers of older adults with dementia symptoms who live at home and the older adults who receive informal care.
  
  
  METHODS
  In this randomized controlled trial, effectiveness as well as cost-effectiveness of case-management is evaluated. It concerns case-management in early-detected patients with dementia symptoms and their primary informal caregivers. Participants are followed up to twelve months after baseline assessment. The main outcome measure of the effect evaluation is the caregiver's sense of competence to care for the older person with dementia symptoms. The economic evaluation is performed from a societal perspective.
  
  
  CONCLUSIONS
  This is one of the first trials on case-management that includes an economic evaluation. In addition, it concerns a tailor-made intervention in early-detected patients with dementia symptoms and their caregivers. The results of this randomized controlled trial will provide valuable information for health professionals and policy makers on effectiveness and cost-effectiveness of early tailor-made case-management for patients and their informal caregivers. Moreover, positive effects will challenge current health care systems to move to more pro-active approaches for this group.
authors.affiliation: Institute for Research in Extramural Medicine, VU University medical center, Van der Boechorststraat 7, 1081 HV Amsterdam, the Netherlands. d.jansen@vumc.nl
authors.forename: Aaltje P D
authors.initials: AP
authors.lastname: Jansen
authors.forename: Hein P J
authors.initials: HP
authors.lastname: van Hout
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.forename: Martine C
authors.initials: MC
authors.lastname: de Bruijne
authors.forename: Judith E
authors.initials: JE
authors.lastname: Bosmans
authors.forename: Anne-Margriet
authors.initials: AM
authors.lastname: Pot
authors.forename: Wim A B
authors.initials: WA
authors.lastname: Stalman
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D019090:Case Management / Q000191:economics*; D003152:Community Health Nursing / Q000191:economics*; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000191:economics / Q000451:nursing*; D006299:Health Services for the Aged / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D017059:Models, Econometric; D009426:Netherlands; D011320:Primary Health Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design