{Reference Type}: Journal Article
{Title}: 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.
{Author}: Eikelboom WS;van den Berg E;Coesmans M;Goudzwaard JA;Koopmanschap M;Lazaar N;van Bruchem-Visser RL;Driesen JJM;den Heijer T;Hoogers S;de Jong FJ;Mattace-Raso F;Thomeer EC;Vrenken S;Vroegindeweij LJHM;Zuidema SU;Singleton EH;van Swieten JC;Ossenkoppele R;Papma JM;
{Journal}: J Alzheimers Dis
{Volume}: 93
{Issue}: 4
{Year}: 2023 May 10
{Factor}: 4.16
{DOI}: 10.3233/JAD-230116
{Abstract}: 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.