Patient Variables Associated with the Assignment of a Formal Dementia Diagnosis to Positively Screened Primary Care Patients.

Background: Main objective was to analyze the associations of patient variables (depression, quality of life, anti-dementia drug treatment, knowledge about dementia) with the assignment of a formal diagnosis of dementia to community-dwelling primary care patients who have screened positive for dementia.

Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner based randomized controlled intervention trial. Present analyses are based on cross-sectional data of 319 positively screened patients (age 70+, living at home) who had not been formally diagnosed with dementia before the screening.

Consequences of clinical case management for caregivers: a systematic review.

Objective: Informal caregivers are deeply involved in the case management process. However, little is known about the consequences of such programs for informal caregivers. This systematic literature review, reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, addressed the consequences of clinical case management programs, whether positive or negative, for caregivers of frail older persons or persons with dementia.

Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial.

The objectives of this cross-sectional analysis were to determine healthcare resource utilization and cost for community-dwelling patients with dementia (PWD) from a payer's and societal perspective, and to analyze the associations between costs and sociodemographic and clinical variables. Analysis of healthcare costs from a payer's perspective was based on a sample of 425 PWD, analysis of healthcare costs from societal perspective on a subsample of 254 PWD and their informal caregivers. Frequency of healthcare resource utilization was assessed by means of questionnaires.

[Academic training of nursing professionals in Germany: further development of nursing expertise - results of the Care-N Study M-V].

Background: The development of innovative health care concepts is needed in order to meet the population's need for nursing care in the future. Nurses take over new and expanded roles with a higher degree of professional autonomy. This requires the further development of academic training options for nursing professionals.

Relatives' burden of caring for people screened positive for dementia in primary care : Results of the DelpHi study.

Background: There is a lack of data describing caregiver burden in primary care where most (informal) caregiving is provided.

Objective: The aims of the paper are to describe the burden of people caring for persons with dementia (PWD) in primary care in multiple dimensions and to analyze factors associated with specific dimensions of caregiver burden.

Material And Methods: Analyses are based on cross-sectional data of the general physician-based, cluster-randomized, controlled intervention trial DelpHi-MV (Dementia: life and person-centered help).

[Testing clinical competencies in undergraduate nursing education using Objective Structured Clinical Examination (OSCE) – a literature review of international practice].

Background: In response to demographic trends in Germany nursing competencies are currently reevaluated. Since these have to be taught and trained in nursing education programs, efficient verification of the success is necessary. OSCEs are internationally well-recognized as a comprehensive tool for that.

Subjective memory impairment: No suitable criteria for case-finding of dementia in primary care.

Introduction: Subjective memory impairment (SMI) might be used for the case-finding of dementia. Present analyses aim to determine the diagnostic value and the predictive ability of SMI and related worries for the discrimination of patients screened positive or negative for dementia.

Methods: The analyses are based on data derived from the ongoing German general practioner (GP)-based, randomized controlled trial DelpHi-MV.

Systematic, early identification of dementia and dementia care management are highly appreciated by general physicians in primary care - results within a cluster-randomized-controlled trial (DelpHi).

Background: There is evidence about the benefits of early detection of dementia and subsequent provision of adequate treatment and care. However, there is a lack of knowledge about the acceptance of detection and intervention procedures. These analyses describe the attitudes of general physicians [GPs] toward 1) dementia in general, 2) systematic detection of people with dementia, and 3) an intervention approach after they have experienced both.

Community-Dwelling People Screened Positive for Dementia in Primary Care: A Comprehensive, Multivariate Descriptive Analysis Using Data from the DelpHi-Study.

Background: Efficient help and care for people with dementia (PWD) is dependent on knowledge about PWD in primary care.

Objective: This analysis comprehensively describes community-dwelling PWD in primary care with respect to various dementia care specific variables.

Methods: The analyses are based on baseline data of the ongoing general practitioner-based, randomized, controlled intervention trial DelpHi-MV (Dementia: life- and person-centered help).

Living Alone with Dementia: Prevalence, Correlates and the Utilization of Health and Nursing Care Services.

Background: Little is known about the proportion and the characteristics of community-dwelling people with dementia (PWD) living alone in Germany.

Objectives: To analyze the prevalence of PWD living alone (with and without the support of an informal caregiver) and socio-demographical and clinical characteristics as well as health and nursing care utilization associated with living alone.

Methods: DelpHi-MV (Dementia: Life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner-based, randomized controlled intervention trial.

Unmet Needs of Community-Dwelling Primary Care Patients with Dementia in Germany: Prevalence and Correlates.

Background: To provide an optimal care for persons with dementia (PWD), their individual unmet needs have to be identified and comprehensively addressed.

Objectives: Present analyses aim to describe the number and types of unmet needs of German primary care patients screened positive for dementia and factors associated with the number of unmet needs.

Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner-based, cluster-randomized controlled intervention trial.

Depressive symptoms and depression in people screened positive for dementia in primary care - results of the DelpHi-study.

Background: Dementia and depression are common syndromes in the elderly. There is lack of knowledge concerning the frequency of depressive symptoms in people with dementia (PWD) and factors associated with depression. The aim of this analysis is to (a) describe the frequency of depressive symptoms in people screened positive for dementia, (b) describe differences between PWD with and without depressive symptoms, and (c) analyze associations between depressive symptoms and other dementia-related variables.

[Expectations, requirements and limitations of future task sharing between the nursing profession and the medical profession: results from the Care-N Study M-V].

Background: The aging population causes a sustained increase in demand of medical and nursing care services. At the same time health care professionals are aging, too. This leads to a growing number of health care gaps.

Qualifications for nurses for the care of patients with dementia and support to their caregivers: A pilot evaluation of the dementia care management curriculum.

Background: A substantial increase of people with dementia (PwD) is predicted for the future. Nurses are taking over important tasks to support PwD, which requires a specialized qualification.

Objectives: The aim was to identify points for revision and to further improve the Dementia Care Manager (DCM) curriculum as a basis for probable qualification of nurses caring for PwD.

Burden of Behavioral and Psychiatric Symptoms in People Screened Positive for Dementia in Primary Care: Results of the DelpHi-Study.

Background: There is limited knowledge about the range and effects of neuropsychiatric symptoms shown by persons with dementia (PWD) living in the community and their related caregiver burden.

Objective: To examine neuropsychiatric symptoms in PWD in primary care with regard to frequency, severity, and burden to caregiver; to compare PWD with and without symptoms with regard to sociodemographics, care-related, and disease-related variables; and to identify variables associated with symptoms.

Methods: A general physician-based epidemiological cohort of 248 people screened positive for dementia over the age of 70 (living at home) and their caregivers, was assessed using the Neuropsychiatric Interview (NPI), sociodemographics, and disease-related variables.

Rates of formal diagnosis of dementia in primary care: The effect of screening.

Background: Screening could improve recognition of dementia in primary care. We sought to determine the effect of screening for dementia in primary care practices on the formal diagnosis rate; the distribution of differential diagnoses; and the factors associated with receiving a formal diagnosis.

Methods: The "Dementia: life- and person-centered help in Mecklenburg-Western Pomerania" is an ongoing general practitioner (GP)-based, randomized, controlled intervention trial.

Rates of formal diagnosis in people screened positive for dementia in primary care: results of the DelpHi-Trial.

Background: Primary data about rates of formal diagnosis of dementia in the German primary care sector are widely lacking.

Objectives: Main objectives are to analyze the rate of syndrome diagnosis in primary care patients who screened positive for dementia, the distribution of differential diagnoses, and factors associated with undiagnosed dementia.

Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is an ongoing general practitioner (GP)-based, randomized, controlled intervention trial.

The benefits of implementing a computerized intervention-management-system (IMS) on delivering integrated dementia care in the primary care setting.

Background: A computerized Intervention-Management-System (IMS) has been developed and implemented to facilitate dementia care management. IMS is a rule-based expert decision support system that matches individual patient characteristics to a computerized knowledge base. One of the most important functionalities of IMS is to support the compilation of the individual intervention plan by systematically identifying unmet needs and suggesting the corresponding specific interventions for recommendation to the general practitioner (GP).

Dementia care management: going new ways in ambulant dementia care within a GP-based randomized controlled intervention trial.

Background: Increasing prevalence of dementia is a major challenge for the German healthcare system. The study DelpHi-MV ("Dementia: life- and person-centered help in Mecklenburg-Western Pomerania") aims to implement and evaluate an innovative subsidiary support system for persons with dementia (PwDs) living at home and their caregivers.

Methods: DelpHi-MV is a GP-based cluster randomized controlled intervention trial.

[Delegation and substitution of specific medical tasks as a future model of health care supply].

Changing health care needs caused by changing demographics lead to an increasing demand for medical and nursing care in Germany. A declining number of general practitioners will soon cause a lack of health care supply in a growing number of regions. Nurses constituting the largest occupational group in the health care system contribute by filling the resulting gap.

Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi): study protocol for a randomised controlled trial.

Background: The provision of appropriate medical and nursing care for people with dementia is a major challenge for the healthcare system in Germany. New models of healthcare provision need to be developed, tested and implemented on the population level. Trials in which collaborative care for dementia in the primary care setting were studied have demonstrated its effectiveness.

[Future nursing opportunities - professionalisation and restructuring of scope of duties].

Demographic trends and expected changes regarding future health care require substantial structural reforms of the German health care system. It is generally assumed that nursing education and training as well as curriculum development and also the competencies of professional nurses must adapt to the changing demands of health care supply. Moreover, the expected shortage of general practitioners demands solutions for easing their growing workload, which will include the assignment of certain services to health care professionals which perform these services autonomously or in behalf of the practitioner.

Frequency of inappropriate drugs in primary care: analysis of a sample of immobile patients who received periodic home visits.

Background: drug intake is associated with the risk of drug-related problems (DRPs), e.g. the intake of PIM.

A curriculum for nurses in Germany undertaking medically-delegated tasks in primary care.

Aim: This paper is a report of a study conducted to develop a qualification for nurses in primary care based on the delegation of medical tasks in order to relieve general practitioners and to supply the population in rural regions today and in the future.

Background: Age-demographic changes will cause medical care supply problems, especially for older people, motivating a re-evaluation of the nursing role in ambulatory medical care.

Methods: An intervention study was conducted in Germany between 1 January 2006 and 31 December 2007, comprising a theoretical and practical phase evaluated by participants, general practitioners and patients through questionnaires, reflection rounds and structured interviews during and after the practice phase.

AGnES: supporting general practitioners with qualified medical practice personnel: model project evaluation regarding quality and acceptance.

Background: The German AGnES (community-based, e-health-assisted systemic support for primary care) project allows general practitioners (GPs) to delegate certain elements of medical care, including house calls, to qualified AGnES employees and thereby provide primary care to a larger number of patients. AGnES projects of various types have been carried out in a number of German federal states from 2005 onward. In this article, an evaluation of the AGnES projects to date is presented.