Abstract
The Quebec government has started implementing an Alzheimer Plan (AP) in 42 family medicine groups (FMGs) to improve the management of patients with dementia. We aimed to evaluate the change in the quality of dementia care management and the rate of cognitive testing and diagnosis after the implementation of this reform. Two independent sets of charts were extracted: one pre (2011–2013) and one post (2014–2015) implementation. We collected data from 13 FMGs in Quebec who have implemented the AP with a total of 945 randomly selected charts of patients 75+ with dementia or MCI and 1919 charts of patients 75+. The score on quality of dementia care management was based on 10 validated quality indicators including the evaluation of cognition, functional status, behaviour, weight, caregiver status, driving ability, medication and support services. We also looked at the proportion of patients 75+ with a cognitive test and with a diagnosis of dementia. The quality of dementia care increased from 44.1% to 52.0% (p<0.001) after the AP. The proportion of patients 75+ with a cognitive test was 14.5% pre and 17.0% post AP; a diagnosis of dementia was present in 13.5% of charts pre and 14.5% post AP. These results provide an initial portrait of the impact of the AP in Quebec. The government plans to use these results to refine the Alzheimer Plan before province-wide dissemination.