2005 Investigator-Initiated Research Grant

A number of professional organizations have developed practice guidelines for the treatment of Alzheimer’s disease based on published literature and expert opinion. In addition, the Alzheimer’s Association has supported several demonstration projects intended to improve the quality and coordination of health care for persons with Alzheimer’s. Studies have shown, however, that widespread implementation of these practices is still lacking.

David B. Reuben, M.D., and colleagues have suggested that successful models have not been implemented because they were not compatible with existing practices and too complex to implement. More importantly, these models have not focused on redesign of the physician’s practice, a shift that is often essential in sustaining a new treatment model.

The current study will build upon methods developed in Assessing Care of the Vulnerable Elderly (ACOVE), a recently completed project designed to test a practice redesign intervention to improve the quality of care that primary care physicians provide their older patients. Dr. Reuben’s group will focus on improving the effectiveness of the ACOVE intervention for dementia.

As part of this enhancement, they will add the resources of Alzheimer’s Association chapters to serve as a “one-stop shop” for patient, caregiver and family education and support, as well as a link to community-based resources. To increase the likelihood of adoption of the intervention, the researchers will conduct focus groups with physicians to learn more about what information from the Association is most valuable to clinicians and how to best provide it.

The investigators will conduct pilot studies of a revised ACOVE practice redesign. The assessment and outcome of this work will provide data for further revisions and tests in a large number of practices—a subsequent study to be funded by the National Institute on Aging.