Table 4:
Mixed-effects model results for patients aged 75 years or more with neurocognitive disorders before and after implementation of the Quebec Alzheimer Plan*
| Variable | No. (%) of patients† | Adjusted mean difference (95% Cl) | ICC | |
|---|---|---|---|---|
| Before n = 455 |
After n = 490 |
|||
| No. of contacts with Family Medicine Group, mean ± SD | 7.9 ± 10.2 | 9.9 ± 9.7 | 1.57 (0.30–2.84) | 0.12 |
| Quality of follow-up score, mean ± SD | 48.0 ± 20.0 | 54.6 ± 18.8 | 6.58 (3.92–9.23) | 0.08 |
| Cognitive testing‡ | 226 (50.1) n = 451 |
239 (49.2) n = 486 |
– | – |
| Evaluation of functional status | 317 (69.7) | 397 (81.0) | – | – |
| Evaluation of behavioural and psychological symptoms of dementia | 318 (69.9) | 398 (81.2) | – | – |
| Evaluation of weightठ| 265 (59.3) n = 447 |
346 (70.9) n = 488 |
– | – |
| Evaluation of caregiver needs¶ | 107 (24.0) n = 445 |
133 (28.0) n = 475 |
– | – |
| Documentation of driving status¶ | 52 (13.1) n = 398 |
98 (23.7) n = 414 |
– | – |
| No anticholinergic medication | 385 (84.6) | 396 (80.8) | – | – |
| Evaluation of home-based service needs | 237 (52.1) | 294 (60.0) | – | – |
| Evaluation of community service needs | 8 (1.8) | 33 (6.7) | – | – |
| Management of dementia medications (memantine and cholinesterase inhibitors)** | 94 (54.3) n = 173 |
105 (66.9) n = 157 |
– | – |
| OR (95% Cl) | ||||
| Antipsychotic medication | 117 (25.7) | 98 (20.0) | 0.66 (0.47–0.95) | 0.04 |
| Memantine or cholinesterase inhibitors prescribed by Family Medicine Group†† | 27 (71.0) n = 38 |
26 (72.2) n = 36 |
0.81 (0.23–2.81) | 0.01 |
| Referral to memory clinic after diagnosis‡‡ | 40 (11.8) n = 338 |
29 (8.5) n = 340 |
0.66 (0.37–1.16) | 0.001 |
| Justified referral§§¶¶ | 31 (77.5) | 27 (93.1) | – | – |
| Uncertainty | 14 (45.2) | 16 (59.3) | – | – |
| Family request | 4 (12.9) | 6 (22.2) | – | – |
| Presence of depression | 2 (6.4) | 3 (11.1) | – | – |
| Complex medication management | 4 (12.9) | 0 (0.0) | – | – |
| Complex patient management | 11 (35.5) | 10 (37.0) | – | – |
| Other reason§§ | 1 (2.5) | 0 (0.0) | – | – |
| Unjustified referral§§ | 8 (20.0) | 2 (6.9) | – | – |
| No prior evaluation | 4 (50.0) | 1 (50.0) | – | – |
| No justification | 4 (50.0) | 1 (50.0) | – | – |
Note: CI = confidence interval, ICC = intraclass correlation coefficient, OR = odds ratio, SD = standard deviation.
Model estimates adjusted for age, sex and number of medications.
Except where noted otherwise.
Excluding patients who refused the evaluation.
Excluding patients for whom the evaluation was not feasible.
Excluding patients for whom the evaluation was not applicable.
Excluding patients who did not take medication or did not had a follow-up visit after the prescription.
Excluding patients who received their prescription before the study period or did not take medication.
Excluding patients referred before the study period.
Proportions of subgroups.
There could be more than 1 reason for referral.