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The development of quality indicators to improve psychosocial care in dementia

Published online by Cambridge University Press:  17 January 2012

Emmelyne Vasse ,
Esme Moniz-Cook ,
Marcel Olde Rikkert ,
Inge Cantegreil ,
Kevin Charras ,
Pascale Dorenlot ,
Georgina Fumero ,
Manuel Franco ,
Bob Woods  and
Myrra Vernooij-Dassen
Emmelyne Vasse*
Affiliation:
Scientific Institute for Quality of Healthcare and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Esme Moniz-Cook
Affiliation:
Institute of Rehabilitation, University of Hull & Humber Mental Health Teaching NHS Trust, Hull, UK
Marcel Olde Rikkert
Affiliation:
Department of Geriatrics and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Inge Cantegreil
Affiliation:
Broca Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
Kevin Charras
Affiliation:
Fondation Médéric Alzheimer, Paris, France
Pascale Dorenlot
Affiliation:
Scientific Director, FOCSS Foundation, Paris, France
Georgina Fumero
Affiliation:
Luso-Castellano Research Institute, Zamora, Spain Intras Foundation, Valladolid, Spain
Manuel Franco
Affiliation:
Intras Foundation, Valladolid, Spain
Bob Woods
Affiliation:
Dementia Services Development Centre, Bangor University, BangorUK
Myrra Vernooij-Dassen
Affiliation:
Scientific Institute for Quality of Healthcare and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Department of Primary and Community Care, Kalorama Foundation, NijmegenThe Netherlands
*
Correspondence should be addressed to: Emmelyne Vasse, Scientific Institute for Quality of Healthcare and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, 114 IQ Healthcare, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Phone: +31-243-666-265; Fax: +31-243-540-166. Email: emmelyne.vasse@hotmail.nl.
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Abstract

Background: The evidence for the effectiveness of psychosocial interventions in dementia care is growing but the implementation of available evidence is not automatic. Our objective was to develop valid quality indicators (QIs) for psychosocial dementia care that facilitate the implementation process in various countries and settings.

Methods: A RAND-modified Delphi technique was used to develop a potential set of QIs. Two multidisciplinary, international expert panels were involved in achieving content and face validity. Consensus on the final set was reached after a conference meeting where a third panel of dementia experts discussed measurability and applicability of the potential set. A retrospective cohort study was conducted to study the feasibility of using the final set in day care centers, hospitals, and nursing homes in Spain and The Netherlands.

Results: A total of 104 recommendations were selected from guidelines and systematic reviews and appraised for their contribution to improving the quality of dementia care by 49 dementia experts. Twenty-five experts attended the conference meeting and reached consensus on a set of 12 QIs representing the key elements of effective psychosocial care, such as shared decision-making and interventions tailored to needs and preferences. Data from 153 patient records showed that all but one QI subitem were applicable to all three settings in both countries.

Conclusion: Our multidisciplinary and multinational strategy resulted in a set of unique QIs that aims exclusively at assessing the quality of psychosocial dementia care. Following implementation, these QIs will assist dementia care professionals to individualize and tailor psychosocial interventions.

Keywords

psychosocial interventionsguidelinesEurope
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 6 , June 2012 , pp. 921 - 930
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Abbey, J., Palk, E., Carlson, L. and Parker, D. (2008). Clinical Practice Guidelines and Care Pathways for People with Dementia Living in the Community. Brisbane, Australia: QUTGoogle Scholar
Alzheimer Europe (2006). Dementia in Europe Yearbook 2006, including the Alzheimer Europe Annual Report 2005. Luxembourg: Alzheimer Europe.Google Scholar
American Psychiatric Association (2007). Practice Guideline for the Treatment of Patients with Alzheimer's Disease and Other Dementias. Arlington, VA: American Psychiatric Association (APA).Google Scholar
Amin, A. et al. (2007). Assessing Care of Vulnerable Elders-3 Quality Indicators. Journal of the American Geriatrics Society, 55 (Suppl. 2), S464–S487.Google Scholar
Campbell, S. M., Braspenning, J., Hutchinson, A. and Marshall, M. (2002). Research methods used in developing and applying quality indicators in primary care. Quality & Safety in Health Care, 11, 358–364.CrossRefGoogle ScholarPubMed
Campbell, S. M., Braspenning, J., Hutchinson, A. and Marshall, M. N. (2003). Research methods used in developing and applying quality indicators in primary care. BMJ, 326, 816–819.CrossRefGoogle ScholarPubMed
Donabedian, A. (2005). Evaluating the quality of medical care. Milbank Quarterly, 83, 691–729.CrossRefGoogle ScholarPubMed
Drasković, I., Vernooij-Dassen, M., Verhey, F., Scheltens, P. and Rikkert, M. O. (2008). Development of quality indicators for memory clinics. International Journal of Geriatric Psychiatry, 23, 119–128.CrossRefGoogle ScholarPubMed
Ferri, C. P. et al. (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Fitch, K. et al. (2001). Classifying appropriateness. In Fitch, K. et al. , The RAND/UCLA Appropriateness Method User's Manual (pp. 56–63). Santa Monica, CA: RAND. Available at: http://www.rand.org/pubs/monograph_reports/MR1269/index.html; last accessed 9 July 2010.Google Scholar
Hall, S. A. (2009). The social inclusion of people with disabilities: a qualitative meta-analysis. Journal of Ethnographic & Qualitative Research, 3, 162–173.Google Scholar
Hogan, D. B. et al. (2008). Diagnosis and treatment of dementia: 5. Nonpharmacologic and pharmacologic therapy for mild to moderate dementia. Canadian Medical Association Journal, 179, 1019–1026.CrossRefGoogle ScholarPubMed
Holmström, I. and Röing, M. (2010). The relation between patient-centeredness and patient empowerment: a discussion on concepts. Patient Education and Counseling, 79, 167–172.CrossRefGoogle ScholarPubMed
Kverno, K. S., Black, B. S., Nolan, M. T. and Rabins, P. V. (2009). Research on treating neuropsychiatric symptoms of advanced dementia with non-pharmacological strategies, 1998–2008: a systematic literature review. International Psychogeriatrics, 21, 825–843.CrossRefGoogle ScholarPubMed
Mangialasche, F., Solomon, A., Winblad, B., Mecocci, P. and Kivipelto, M. (2010). Alzheimer's disease: clinical trials and drug development. Lancet Neurology, 9, 702–716.CrossRefGoogle ScholarPubMed
Marshall, M. N., Shekelle, P. G., McGlynn, E. A., Campbell, S., Brook, R. H. and Roland, M. O. (2003). Can health care quality indicators be transferred between countries? Quality & Safety in Health Care, 12, 8–12.CrossRefGoogle ScholarPubMed
Moise, P., Schwarzinger, M. and Um, M.-Y. (2004) Dementia Care in Nine OECD Countries: A Comparative Analysis. OECD Health Working Papers No. 13. Available at: http://www.oecd.org/dataoecd/10/52/33661491.pdf; last accessed 21 July 2010.Google Scholar
Moniz-Cook, E., Vernooij-Dassen, M., Woods, B. and Orrell, M. (2011). Psychosocial interventions in dementia care research: the INTERDEM manifesto. Aging & Mental Health, 15, 283–290.CrossRefGoogle ScholarPubMed
National Guideline Clearinghouse (NGC) (2006). Guideline Synthesis: Management of Alzheimer's Disease and Related Dementias. Rockville, MD: National Guideline Clearinghouse. Available at: http://www.guideline.gov; last accessed 22 March 2010.Google Scholar
O'Connor, D. W., Ames, D., Gardner, B. and King, M. (2009). Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. International Psychogeriatrics, 21, 225–240.CrossRefGoogle ScholarPubMed
Olazarán, J. et al. (2010). Non-pharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dementia and Geriatric Cognitive Disorders, 30, 161–178.CrossRefGoogle Scholar
Peabody, J. W., Luck, J., Glassman, P., Dresselhaus, T. R. and Lee, M. (2000). Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA, 283, 1715–1722.CrossRefGoogle ScholarPubMed
Perry, M. et al. (2010). Development and validation of quality indicators for dementia diagnosis and management in a primary care setting. Journal of the American Geriatrics Society, 58, 557–563.CrossRefGoogle Scholar
Powell, A. E., Davies, H. T. O. and Thomson, R. G. (2003). Using routine comparative data to assess the quality of health care: understanding and avoiding common pitfalls. Quality & Safety in Health Care, 12, 122–128.CrossRefGoogle ScholarPubMed
Reuben, D. B. et al. (2010) Assessing care of vulnerable elders-Alzheimer's disease: a pilot study of a practice redesign intervention to improve the quality of dementia care. Journal of the American Geriatrics Society, 58, 324–329.CrossRefGoogle ScholarPubMed
Rimmer, E., Wojciechowska, M., Stave, C., Sganga, A. and O'Connell, B. (2005). Implications of the Facing Dementia Survey for the general population, patients and caregivers across Europe. International Journal of Clinical Practice, 59 (Suppl. 146), 17–24.CrossRefGoogle Scholar
Saliba, D. et al. (2005). Feasibility of quality indicators for the management of geriatric syndromes in nursing home residents. Journal of the American Medical Directors Association, 6 (Suppl. 3), S50–S59.CrossRefGoogle ScholarPubMed
Vasse, E. et al. (2008). European guidelines on psychosocial interventions. In Dementia in Europe Yearbook 2008 (pp. 88–120). Luxembourg: Alzheimer Europe.Google Scholar
Vasse, E. et al. (2012). Guidelines for psychosocial interventions in dementia care: a European survey and comparison. International Journal of Geriatric Psychiatry, 27, 40–48.CrossRefGoogle Scholar
Vickrey, B. G. et al. (2006). The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial. Annals of Internal Medicine, 145, 713–726.CrossRefGoogle ScholarPubMed