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The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial
Vickrey BG, Mittman BS, Connor KI, Pearson ML, Della Penna RD, Ganiats TG, Demonte RW, Chodosh J et al.. Annals of internal medicine, 2006-11-01
Topic: Risk, prevention and care in population studies
Background Adherence to dementia guidelines is poor despite evidence that some guideline recommendations can improve symptoms and delay institutionalization of patients. Objective To test the effectiveness of a dementia guideline-based disease management program on quality of care and outcomes for patients with dementia. Design Clinic-level, cluster randomized, controlled trial. Setting 3 health care organizations collaborating with 3 community agencies in southern California. Participants 18 primary care clinics and 408 patients with dementia age 65 years or older paired with 408 informal caregivers. Intervention Disease management program led by care managers and provided to 238 patient-caregiver pairs at 9 intervention clinics for more than 12 months. Measurements Adherence to 23 guideline recommendations (primary outcome) and receipt of community resources and patient and caregiver health and quality-of-care measures (secondary outcomes). Results The mean percentage of per-patient guideline recommendations to which care was adherent was significantly higher in the intervention group than in the usual care group (63.9% vs. 32.9%, respectively; adjusted difference, 30.1% [95% CI, 25.2% to 34.9%]; P Limitations Participants were well-educated, were predominantly white, had a usual source of care, and were not institutionalized. Generalizability to other patients and geographic regions is unknown. Also, costs of a care management program under fee-for-service reimbursement may impede adoption. Conclusions A dementia guideline-based disease management program led to substantial improvements in quality of care for patients with dementia. Current Controlled Trials identifier: ISRCTN72577751.
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APA 7th
Vickrey, B. G., Mittman, B. S., Connor, K. I., Pearson, M. L., Della Penna, R. D., Ganiats, T. 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. https://doi.org/10.7326/0003-4819-145-10-200611210-00004
Vancouver
Vickrey BG, Mittman BS, Connor KI, Pearson ML, Della Penna RD, Ganiats TG, et al. The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial. Annals of internal medicine. 2006. doi:10.7326/0003-4819-145-10-200611210-00004. PMID: 17116916.
BibTeX
@article{vickrey2006-17116916,
author = {Vickrey, B. G. and Mittman, B. S. and Connor, K. I. and Pearson, M. L. and Della Penna, R. D. and Ganiats, T. G. and Demonte, R. W. and Chodosh, J. and others},
title = {{The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial}},
journal = {Annals of internal medicine},
year = {2006},
doi = {10.7326/0003-4819-145-10-200611210-00004},
pmid = {17116916},
url = {https://doi.org/10.7326/0003-4819-145-10-200611210-00004}
}
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Key findings
- Results The mean percentage of per-patient guideline recommendations to which care was adherent was significantly higher in the intervention group than in the usual care group (63.9% vs. 32.9%, respectively; adjusted difference, 30.1% [95% CI, 25.2% to 34.9%]; P < 0.001).
Why it matters
This randomised trial found that a dementia guideline-based disease management program led by care managers improved adherence to guideline recommendations compared with usual care. The authors noted the participants were well-educated, mostly white, and not institutionalised, which may limit how far the results apply to other patients.
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Study details
- Participants408
- Effect size63.9%; 32.9%; 30.1%
- Evidence strengthHigh
How this study scored 68/100
Published in a leading specialty journal, and it is a randomized controlled trial. We have no data on senior author's track record, so that was left out: it earned 65 of the 96 points we could judge it on, which is 68 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of internal medicine) |
| Journal's citation record | 4 / 4 | Annals of Internal Medicine: journal h-index 648 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomized controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 2 / 4 | 408 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 1 / 2 | Randomized (as stated in the record) |
| Times cited | 4 / 7 | Cited 44 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 3 / 6 | Cited 3.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 26 other studies in this library |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 2 / 3 | University of California, Los Angeles: institution h-index 1,923 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17116916) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 65 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 65 of the 96 points we could judge it on is 68 out of 100. |
| Total | 68 / 100 | — |
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