Efficacy of care management in reducing needs of caregivers of people with dementia

Background People living with dementia (PlwD) in Germany are primarily cared for by informal caregivers who often face health problems, social isolation, and low quality of life. Identifying and addressing their needs is crucial for their well-being and the stability of the care arrangement. The aim of the study was to investigate the efficacy of a digitally supported care management program for informal caregivers for PlwD. Methods Longitudinal, cluster-randomized controlled trial in a primary care setting in Germany. The intervention is based on a comprehensive tablet-based self-assessment in GPs practices and memory clinics, using pre-specified algorithms to identify unmet needs and develop an individualized support and care plan for each caregiver. The care managers conducted home visits, discussing, adapting, and actively supporting plan implementation over six months. Primary outcomes included the number of unmet needs after six months and the caregiver’s health-related quality of life. Secondary outcomes were caregiver burden and social network. Statistical analyses include descriptive analyses as well as different clustered linear and Poisson regression models (base: adjusted only for baseline value and multivariate: adjusted for additional variables). Results 192 informal caregivers of community-dwelling PlwD partook in the study, randomized into control (n = 96, care as usual) and intervention (n = 96) groups. In the base analysis the the reduction of needs overall was significantly better in the intervention group compared to the control group. However, the multivariate analysis alleviated this effect. We saw no effect on health-related quality of life or the secondary outcomes. Conclusions Our study delivers ambivalent results for the efficacy of care management for caregivers. Unmet needs could be reduced, but the size of this effect decreases with more variables in the model. Also, no effects on other variables could be shown. Care management shows some potential but needs further refinement and tailoring.