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BMC Res Notes. 2015 Jun 4;8:217. doi: 10.1186/s13104-015-1189-6.

The benefit of a geriatric nurse practitioner in a multidisciplinary diagnostic service for people with cognitive disorders.

Author information

1
CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. bart.ament@maastrichtuniversity.nl.
2
Alzheimer Centre Limburg, MHeNS School for Mental Health and NeuroScience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. bart.ament@maastrichtuniversity.nl.
3
Department of Health Services Research, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. bart.ament@maastrichtuniversity.nl.
4
Alzheimer Centre Limburg, MHeNS School for Mental Health and NeuroScience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. claire.wolfs@maastrichtuniversity.nl.
5
CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. g.kempen@maastrichtuniversity.nl.
6
Department of Health Services Research, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. g.kempen@maastrichtuniversity.nl.
7
CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. ton.ambergen@maastrichtuniversity.nl.
8
Alzheimer Centre Limburg, MHeNS School for Mental Health and NeuroScience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. f.verhey@maastrichtuniversity.nl.
9
Alzheimer Centre Limburg, MHeNS School for Mental Health and NeuroScience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. m.devugt@maastrichtuniversity.nl.

Abstract

BACKGROUND:

The aim of the study was to evaluate whether adding a geriatric nurse practitioner (GNP) to an outpatient diagnostic multidisciplinary facility for patients with cognitive disorders (Diagnostic Observation Center for PsychoGeriatry, DOC-PG) could improve quality of care. DOC-PG combines hospital diagnostics and care assessment from a community mental health team and provides the general practitioner (GP) with advice for treatment and management. In a previous study, we found that 28.7% of the advice made by this service was not followed up on by the GP.

METHODS:

Two cohorts were studied: a group of patients with added GNP (n = 114) and a historical reference sample (n = 137). Both groups followed the same diagnostic protocol and care approach, but, in the GNP group, a care coordinator was added in order to communicate the advice from the DOC-PG to the GP. The primary outcome was the concordance rate of GPs regarding the advice. At the patient level, health-related quality of life (HRQoL) was assessed. Self-Rated Burden and care-related quality of life were measured at the informal caregiver level. Measures were conducted immediately after DOC-PG diagnosis and after 6 and 12 months. Univariate analyses, logistic regression analyses, and mixed model multilevel analyses were used to test differences between both groups.

RESULTS:

Total concordance rates were significantly higher in the GNP group compared to the reference sample (82.1 and 71.3%, respectively; p < 0.001). No improvement in patient HRQoL was identified. Among the informal caregivers, a significant reduction of Self-Rated Burden was found in the GNP group at 12 months (adjusted mean difference -1.724, 95% CI -2.582 to -0.866; p < 0.001).

CONCLUSIONS:

Adding a GNP to an outpatient diagnostic multidisciplinary facility for patients with cognitive disorders may improve the GP concordance rate of the advice from the DOC-PG and reduce subjective burden of the informal caregiver.

PMID:
26040514
PMCID:
PMC4455984
DOI:
10.1186/s13104-015-1189-6
[Indexed for MEDLINE]
Free PMC Article

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