%0 Journal Article
%T Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer's Disease at the Memory Clinic: The BEAT-IT Study.
%A Eikelboom WS
%A van den Berg E
%A Coesmans M
%A Goudzwaard JA
%A Koopmanschap M
%A Lazaar N
%A van Bruchem-Visser RL
%A Driesen JJM
%A den Heijer T
%A Hoogers S
%A de Jong FJ
%A Mattace-Raso F
%A Thomeer EC
%A Vrenken S
%A Vroegindeweij LJHM
%A Zuidema SU
%A Singleton EH
%A van Swieten JC
%A Ossenkoppele R
%A Papma JM
%J J Alzheimers Dis
%V 93
%N 4
%D 2023 May 10
%M 37182887
%F 4.16
%R 10.3233/JAD-230116
%X Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer's disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented.<BR>To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic.<BR>We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden, NPS severity, NPS-related distress, competence managing NPS, and psychotropic drug use. Reliable change index was calculated to identify responders to the intervention. A cost-effectiveness analysis was performed and semi-structured interviews with a subsample of the intervention group (n = 12).<BR>The DICE method did not improve any outcomes over time compared to care as usual. Half of the participants of the intervention group (52%) were identified as responders and showed more NPS and NPS-related distress at baseline compared to non-responders. Interviews revealed substantial heterogeneity among participants regarding NPS-related distress, caregiver burden, and availability of social support. The intervention did not lead to significant gains in quality-adjusted life years and well-being years nor clear savings in health care and societal costs.<BR>The DICE method showed no benefits at group-level, but individuals with high levels of NPS and NPS-related distress may benefit from this intervention.