Neurology Central

Major health improvements achieved with novel population health management program

A new study from the Regenstrief Institute, Indiana University Center for Aging Research and Eskenazi Health (all IN, USA) has presented the results of a novel population health management program, termed The Aging Brain Care (ABC) Medical Home. The program, which was implemented in homes of older adults, showed significant improvements in health for individuals suffering with depression, as well as a substantial reduction in stress for family caregivers of dementia patients.

At least a 50% reduction in symptoms was seen in two-thirds of patients with moderately severe depressive symptoms (feeling hopeless, bad about oneself or trouble concentrating), in addition to a 50% reduction in symptoms of stress in half of caregivers for dementia patients.

Lead author, Michael LaMantia (Regenstrief Institute investigator and Indiana University Center for Aging Research), explained the program: “Care coordinator assistants go to patients’ homes, develop relationships with them, evaluate the safety of the home environment, focus on the needs of both patients and caregivers, and offer support to deal with the many consequences of a depression or dementia diagnosis.”

Coordinator care assistants are responsible for monitoring symptom burden, coaching patients with a history of depression on implementing behavioral activation and relapse prevention activities, as well as working with caregivers of patients with dementia on the implementation of stress prevention strategies. These include encouraging attendance at support groups, developing crisis plans, taking regular time off, and enhancing their self-management and problem solving capacity. On average within this study participants received 13 home visits over the 18-month period in which data was collected.

The ABC Medical Care program feeds into the Indiana Network for Patient Care highlighting to the team whenever a patient visits an emergency department or is admitted to a hospital anywhere in the state; ultimately enabling coordination of services that will be needed on a patients discharge.

“Depression and dementia, which typically impact other medical conditions, are difficult for primary care doctors to treat during their limited time with patients,” commented Michael LaMantia. “The Aging Brain Care Medical Home program may be an attractive option in response to some of the challenges posed by our nation’s rapidly aging population and the anticipated lack of geriatricians and primary doctors to care for them.”

Source: Indiana University School of Medicine