• Joshua Chodosh, Elise Berry, Martin Lee, Karen Connor, Robert DeMonte, Theodore Ganiats, Lisa Heikoff, Laurence Rubenstein, Brian Mittman, and Barbara Vickrey.
• Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA. jchodosh@mednet.ucla.edu
• J Am Geriatr Soc. 2006 Feb 1; 54 (2): 311-7.

ObjectivesTo evaluate the effect of a multicomponent dementia care management program on primary care provider knowledge, attitudes, and perceptions of quality of dementia care.DesignA clinic-level randomized, controlled trial of a comprehensive care management program for patients with dementia and their nonprofessional caregivers. The program included provider education and protocols for care managers to communicate with patients' medical providers.SettingEighteen clinics (nine intervention, nine [corrected] usual care) in three healthcare systems in San Diego, California.ParticipantsTwo hundred thirty-two medical providers; 129 from nine [corrected] intervention clinics; 103 from nine [corrected] usual-care clinics.MeasurementsProviders were surveyed 9 months after intervention onset on knowledge (five items on four topics), attitudes about dementia (three items), and perception of quality of dementia care in their practice setting (three items). Multivariable linear and logistic regression models were used to evaluate the differences between intervention and usual-care providers, adjusting for covariate effects across groups and clustering by clinic.ResultsOne hundred sixty-six of 232 (72%) providers responded. Intervention providers had better knowledge about assessing decision-making capacity than usual-care providers (adjusted difference in percentage correct = 12%; adjusted odds ratio = 2.4, 95% confidence interval = 1.2-4.8). Intervention providers viewed dementia patients as more difficult to manage in primary care than usual-care providers (P = .03). There were no other differences in knowledge, attitudes, or care quality perceptions across intervention and usual-care providers.ConclusionA comprehensive dementia care management model resulted in few differences in provider knowledge or attitudes favorable to dementia care, suggesting that this care model's effects on quality were primarily mediated through other components of the care management program.

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