Patient Navigation Programs for People With Dementia

Abstract

Patient navigation programs are generally community-based service delivery interventions (such as collaborative care, coordinated care, and case management) intended to enhance timely access to the diagnosis and treatment of individuals with chronic conditions, including dementia. Overall, for coordinated care compared with usual care, clinical findings were either mixed or there were no between-group differences in terms of hospitalization, institutionalization, or nursing home admissions; quality of life; or symptoms. For coordinated care compared with usual care, there was no statistically significant between-group difference in mortality. However, there was evidence of improvement in terms of behaviour with coordinated care compared with usual care. According to 1 economic evaluation, for patients with dementia, with the majority having no or mild cognitive impairment, collaborative dementia care management provided increased benefit (quality-adjusted life-years gained) at decreased cost. Three guidelines were identified that provided recommendations for care coordination. One guideline recommends coordinated care for people living with dementia that is organized by a single-named health or social care professional. The second guideline recommends the use of digital technology to enhance care coordination in persons with mental illness. The third guideline recommends coordinated care for people with delirium, dementia, and depression. Findings need to be interpreted in the light of limitations (such as lack of information in the study populations’ type of dementia, mixed findings in outcomes, and lack of information beyond 24 months of follow-up).