Int J Nurs Stud. 2021 Jun 26;121:104012. doi: 10.1016/j.ijnurstu.2021.104012. Online ahead of print.
ABSTRACT
BACKGROUND: Case management has been developed and suggested as a method for improving the quality of dementia care by optimising care service and delivery using a feasible and cost-effective approach. However, the effects of case management for improving dementia care remain inconclusive.
AIM: To analyse the efficacy of case management interventions for people with dementia and their carers.
DESIGN: Systematic review and meta-analysis.
METHODS: This study conducted a systematic review of the literature from January 1, 2002, to March 15, 2021, indexed in the following databases: Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, OVID, and Web of Science. Intervention studies examining patients with dementia and their carers published in the English language were included. The methodological quality of included studies was evaluated using the PEDro scale. The meta-analysis was performed using a random-effects model to calculate the pooled standardised mean difference (SMD) of case management intervention outcomes for both people with dementia (cognitive function, neuropsychiatric symptoms, and quality of life) and their carers (carer burden). Stata 16.0 was used for statistical analysis.
RESULTS: A total of eight studies met the eligibility criteria for this study. The results of the quantitative analysis, ranging from 6 to 18 months, showed no significant effect on cognitive function, quality of life over 12 months and longer, and carer burden over time between groups with and without intervention. However, significant improvements were observed for neuropsychiatric symptoms over 12 months and longer and quality of life at six months in the case management group.
CONCLUSION: Case management appears to have the potential to improve the health outcomes among people with dementia. However, these conclusions are limited due to the lack of conducted studies. Future work examining intervention outcomes remains necessary to explore the effects of interventions on the mental and physical wellbeing of carers.
PMID:34265500 | DOI:10.1016/j.ijnurstu.2021.104012
