This study was supported by the California HealthCare Foundation, Oakland, California, by funds received from the State of California Department of Health Services, Office of Long-term Care, and Contract 013608–001 for the UCLA Alzheimer's Disease Research Center. Dr. Chodosh is a current recipient of a Health Services Research and Development Veterans Administration Career Development Award (HSR & D RCD 00–022).
Effect of a Dementia Care Management Intervention on Primary Care Provider Knowledge, Attitudes, and Perceptions of Quality of Care
Article first published online: 2 DEC 2005
Journal of the American Geriatrics Society
Volume 54, Issue 2, pages 311–317, February 2006
How to Cite
Chodosh, J., Berry, E., Lee, M., Connor, K., DeMonte, R., Ganiats, T., Heikoff, L., Rubenstein, L., Mittman, B. and Vickrey, B. (2006), Effect of a Dementia Care Management Intervention on Primary Care Provider Knowledge, Attitudes, and Perceptions of Quality of Care. Journal of the American Geriatrics Society, 54: 311–317. doi: 10.1111/j.1532-5415.2005.00564.x
- Issue published online: 2 DEC 2005
- Article first published online: 2 DEC 2005
Vol. 54, Issue 9, 1479, Article first published online: 7 SEP 2006
- quality of care;
- provider knowledge
OBJECTIVES: To evaluate the effect of a multicomponent dementia care management program on primary care provider knowledge, attitudes, and perceptions of quality of dementia care.
DESIGN: A clinic-level randomized, controlled trial of a comprehensive care management program for patients with dementia and their nonprofessional caregivers. The program included provider education and protocols for care managers to communicate with patients' medical providers.
SETTING: Sixteen clinics (eight intervention, eight usual care) in three healthcare systems in San Diego, California.
PARTICIPANTS: Two hundred thirty-two medical providers; 129 from eight intervention clinics; 103 from eight usual-care clinics.
MEASUREMENTS: Providers were surveyed 9 months after intervention onset on knowledge (five items on four topics), attitudes about dementia (three items), and perception of quality of dementia care in their practice setting (three items). Multivariable linear and logistic regression models were used to evaluate the differences between intervention and usual-care providers, adjusting for covariate effects across groups and clustering by clinic.
RESULTS: One hundred sixty-six of 232 (72%) providers responded. Intervention providers had better knowledge about assessing decision-making capacity than usual-care providers (adjusted difference in percentage correct=12%; adjusted odds ratio=2.4, 95% confidence interval=1.2–4.8). Intervention providers viewed dementia patients as more difficult to manage in primary care than usual-care providers (P=.03). There were no other differences in knowledge, attitudes, or care quality perceptions across intervention and usual-care providers.
CONCLUSION: A comprehensive dementia care management model resulted in few differences in provider knowledge or attitudes favorable to dementia care, suggesting that this care model's effects on quality were primarily mediated through other components of the care management program.