Proactive Primary Dementia Care: Integration of public health and medical home principles to improve outcomes

Dementia, an age-associated clinical syndrome characterized by irreversible decline in memory and cognitive abilities, is a growing public health problem in the U.S. due to projected increases in prevalence for decades to come among all racial and ethnic groups. Efforts to enhance primary care for people with dementia and their family caregivers through randomized trials at academic health centers have yielded positive results, but none has shown sustainability beyond the study period or been replicated in community-based primary care settings.

This presentation will describe the key features of, and progress in implementing, an NIH-funded project called Proactive Primary Dementia Care (PPDC). The PPDC model utilizes a nurse practitioner (NP) with geropsychiatry competencies as the interventionist, and the NP joins primary care group practices to provide protocol-driven care to patients with diagnosed dementia and their family caregivers. Care protocols are adapted from those used in a completed, successful randomized trial at an academic health center. The PPDC model concept integrates public health and medical home principles in an effort to reach those affected by dementia at a broad community level through coordinated care based in primary care practice sites. To date, the PPDC NP has been trained and introduced to primary care practitioners with whom she will work. Subject recruitment will begin in March 2010. The presentation will include details about the study design, outcome-based evaluation strategies, subject recruitment progress, and preliminary findings regarding acceptability of the NP by primary care practitioners.

Funded by the National Institute for Nursing Research (R21NR011127)