title: Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial.
abstract: OBJECTIVE
  To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners.
  
  
  METHODS
  Multicentre randomised controlled trial.
  
  
  METHODS
  Nine memory clinics and 159 general practitioners in the Netherlands.
  
  
  METHODS
  175 patients with a new diagnosis of mild to moderate dementia living in the community and their informal caregivers.
  
  
  METHODS
  Usual care provided by memory clinic or general practitioner.
  
  
  METHODS
  Caregiver rated quality of life of the patient measured with the quality of life in Alzheimer's disease instrument and self perceived burden of the informal caregiver measured with the sense of competence questionnaire (intention to treat analysis).
  
  
  RESULTS
  The quality of life of the patients in the memory clinic group was 0.5 (95% confidence interval -0.7 to 1.6) points higher than in the general practitioner group. Caregivers' burden was 2.4 (-5.8 to 1.0) points lower in the memory clinic group than in the general practitioner group.
  
  
  CONCLUSIONS
  No evidence was found that memory clinics were more effective than general practitioners with regard to post-diagnosis treatment and coordination care for patients with dementia. Without further evidence on the effectiveness of these modalities, other arguments, such as cost minimisation, patients' preferences, or regional health service planning, can determine which type of dementia care is offered.
  
  
  BACKGROUND
  Clinical trials NCT00554047.
authors.affiliation: Department of Geriatrics/Alzheimer Centre Nijmegen, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, Netherlands. e.meeuwsen@ger.umcn.nl
authors.forename: Els J
authors.initials: EJ
authors.lastname: Meeuwsen
authors.forename: René J F
authors.initials: RJ
authors.lastname: Melis
authors.forename: Geert C H M
authors.initials: GC
authors.lastname: Van Der Aa
authors.forename: Gertie A M
authors.initials: GA
authors.lastname: Golüke-Willemse
authors.forename: Benoit J M
authors.initials: BJ
authors.lastname: De Leest
authors.forename: Frank H J M
authors.initials: FH
authors.lastname: Van Raak
authors.forename: Carla J M
authors.initials: CJ
authors.lastname: Schölzel-Dorenbos
authors.forename: Desiree C M
authors.initials: DC
authors.lastname: Verheijen
authors.forename: Frans R J
authors.initials: FR
authors.lastname: Verhey
authors.forename: Marieke C
authors.initials: MC
authors.lastname: Visser
authors.forename: Claire A
authors.initials: CA
authors.lastname: Wolfs
authors.forename: Eddy M M
authors.initials: EM
authors.lastname: Adang
authors.forename: Marcel G M
authors.initials: MG
authors.lastname: Olde Rikkert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D017281:Cost of Illness; D003704:Dementia / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D011788:Quality of Life