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@ARTICLE{Rdke:281827,
author = {Rädke, Anika and Michalowsky, Bernhard and Kleinke, Fabian
and Platen, Moritz and Scharf, Annelie and Pfaff, Michelle
and Buchholz, Maresa and Mühlichen, Franka and Penndorf,
Peter and Schade, Stefanie and Dombrowski, Janina and Lerch,
Pia Elisa Madaida and Reber, Katrin Christiane and
Austenat-Wied, Manon and Martens, Cornelia and van den Berg,
Neeltje and Hoffmann, Wolfgang},
title = {{E}fficacy and cost-effectiveness of extended nursing roles
in dementia care: {R}esults of the cluster-randomized trial
{I}n{D}e{P}endent.},
journal = {Alzheimer's and dementia},
volume = {21},
number = {10},
issn = {1552-5260},
address = {Hoboken, NJ},
publisher = {Wiley},
reportid = {DZNE-2025-01208},
pages = {e70727},
year = {2025},
abstract = {Extended nursing roles in dementia can improve treatment,
care, and patient and caregiver outcomes. We tested the
efficacy and cost-effectiveness in people living with
dementia (PlwD) and caregivers.We analyzed data from 417
PlwD within the multicenter, cluster-randomized InDePendent
trial six months after baseline. Specifically, qualified
nurses carried out advanced dementia care management
individually tailored to each patient's and caregiver's
needs. Outcomes included unmet needs (CANE), quality of life
(QoL-AD, EQ-5D), caregiver burden (Zarit), and
cost-effectiveness (FIMA, RUD).PlwD receiving the
intervention had $74\%$ lower unmet needs (0.26, $CI95\%:$
0.17 to 0.40, p < 0.001) and higher quality of life (0.04,
$CI95\%:$ 0.01 to 0.07, p = 0.017) than controls. There was
a gain in quality-adjusted life years (0.01, $CI95\%:$
-0.001 to 0.018) at slightly higher costs (1,425 EUR,
$CI95\%:$ 638 to 2,211). There was no effect on caregiver
burden after six months.The results provide evidence for the
efficacy and cost-effectiveness of extended nursing roles in
dementia care, demonstrating that extended nursing roles
reduce unmet needs and improve quality of life.This trial
was prospectively registered on ClinicalTrials.gov under the
identifier NCT04741932 on February 2, 2021.The InDePendent
intervention significantly reduced the number of unmet needs
in PlwD and their caregiver according to CANE. Extended
nursing roles can improve PlwD's health-related Quality of
Life. Advanced dementia care management were likely to be
cost-effective after six months.},
keywords = {Humans / Dementia: nursing / Dementia: economics /
Cost-Benefit Analysis / Caregivers: psychology / Female /
Male / Quality of Life / Aged / Nurse's Role / Aged, 80 and
over / Quality-Adjusted Life Years / advanced nursing
(Other) / cost‐effectiveness (Other) / dementia (Other) /
primary care (Other) / randomized controlled trial (Other) /
unmet needs (Other)},
cin = {AG Hoffmann / AG Michalowsky},
ddc = {610},
cid = {I:(DE-2719)1510600 / I:(DE-2719)5000067},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41143334},
pmc = {pmc:PMC12556587},
doi = {10.1002/alz.70727},
url = {https://pub.dzne.de/record/281827},
}