{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:39:39Z","timestamp":1782999579529,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T00:00:00Z","timestamp":1601942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["PCS\u20102017C1\u20106534"],"award-info":[{"award-number":["PCS\u20102017C1\u20106534"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND\/OBJECTIVES<\/jats:title>\n                    <jats:p>Although several approaches have been developed to provide comprehensive care for persons living with dementia (PWD) and their family or friend caregivers, the relative effectiveness and cost effectiveness of community\u2010based dementia care (CBDC) versus health system\u2013based dementia care (CBDC) and the effectiveness of both approaches compared with usual care (UC) are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Pragmatic randomized three\u2010arm superiority trial. The unit of randomization is the PWD\/caregiver dyad.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Four clinical trial sites (CTSs) based in academic and clinical health systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>A total of 2,150 English\u2010 or Spanish\u2010speaking PWD who are not receiving hospice or residing in a nursing home and their caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>INTERVENTIONS<\/jats:title>\n                    <jats:p>Eighteen months of (1) HSDC provided by a nurse practitioner or physician's assistant dementia care specialist who works within the health system, or (2) CBDC provided by a social worker or nurse care consultant who works at a community\u2010based organization, or (3) UC with as needed referral to the Alzheimer's Association Helpline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>Primary outcomes: PWD behavioral symptoms and caregiver distress as measured by the Neuropsychiatric Inventory Questionnaire (NPI\u2010Q) Severity and Modified Caregiver Strain Index scales. Secondary outcomes: NPI\u2010Q Distress, caregiver unmet needs and confidence, and caregiver depressive symptoms. Tertiary outcomes: PWD long\u2010term nursing home placement rates, caregiver\u2010reported PWD functional status, cognition, goal attainment, \u201ctime spent at home,\u201d Dementia Burden Scale\u2010Caregiver, a composite measure of clinical benefit, Quality of Life of persons with dementia, Positive Aspects of Caregiving, and cost effectiveness using intervention costs and Medicare claims.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The results will be reported in the spring of 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>D\u2010CARE will address whether emphasis on clinical support and tighter integration with other medical services has greater benefit than emphasis on social support that is tied more closely to community resources. It will also assess the effectiveness of both interventions compared with UC and will evaluate the cost effectiveness of each intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16862","type":"journal-article","created":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T08:24:54Z","timestamp":1600503894000},"page":"2492-2499","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["<scp>D\u2010CARE:<\/scp>\n                    The Dementia Care Study: Design of a Pragmatic Trial of the Effectiveness and Cost Effectiveness of Health System\u2013Based Versus Community\u2010Based Dementia Care Versus Usual Dementia Care"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1363-4745","authenticated-orcid":false,"given":"David B.","family":"Reuben","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Geriatrics David Geffen School of Medicine at 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