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BMC Research Notes

, 8:217

First Online: 04 June 2015Received: 07 November 2013Accepted: 20 May 2015DOI: 10.1186-s13104-015-1189-6

Cite this article as: Ament, B.H.L., Wolfs, C.A.G., Kempen, G.I.J.M. et al. BMC Res Notes 2015 8: 217. doi:10.1186-s13104-015-1189-6

Abstract

BackgroundThe aim of the study was to evaluate whether adding a geriatric nurse practitioner GNP to an outpatient diagnostic multidisciplinary facility for patients with cognitive disorders Diagnostic Observation Center for PsychoGeriatry, DOC-PG could improve quality of care. DOC-PG combines hospital diagnostics and care assessment from a community mental health team and provides the general practitioner GP with advice for treatment and management. In a previous study, we found that 28.7% of the advice made by this service was not followed up on by the GP.

MethodsTwo cohorts were studied: a group of patients with added GNP n = 114 and a historical reference sample n = 137. Both groups followed the same diagnostic protocol and care approach, but, in the GNP group, a care coordinator was added in order to communicate the advice from the DOC-PG to the GP. The primary outcome was the concordance rate of GPs regarding the advice. At the patient level, health-related quality of life HRQoL was assessed. Self-Rated Burden and care-related quality of life were measured at the informal caregiver level. Measures were conducted immediately after DOC-PG diagnosis and after 6 and 12 months. Univariate analyses, logistic regression analyses, and mixed model multilevel analyses were used to test differences between both groups.

ResultsTotal concordance rates were significantly higher in the GNP group compared to the reference sample 82.1 and 71.3%, respectively; p < 0.001. No improvement in patient HRQoL was identified. Among the informal caregivers, a significant reduction of Self-Rated Burden was found in the GNP group at 12 months adjusted mean difference −1.724, 95% CI −2.582 to −0.866; p < 0.001.

ConclusionsAdding a GNP to an outpatient diagnostic multidisciplinary facility for patients with cognitive disorders may improve the GP concordance rate of the advice from the DOC-PG and reduce subjective burden of the informal caregiver.

KeywordsDementia Integrated care GP concordance Geriatric nurse practitioner AbbreviationsGPgeneral practitioner

GNPgeriatric nurse practitioner

DOC-PGDiagnostic Observation Center for PsychoGeriatry

HRQoLhealth-related quality of life

CarerQoLcare-related quality of life

VASvisual analogue scale

MMSEmini-mental state examination

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Autor: Bart H L Ament - Claire A G Wolfs - Gertrudis I J M Kempen - Ton Ambergen - Frans R J Verhey - Marjolein E De Vugt

Fuente: https://link.springer.com/







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