OBJECTIVES: To evaluate whether 6 months of collaborative dementia care management (CDCM) is associated with improved patient clinical outcomes and caregiver burden and is cost-effective compared with usual care over 36 months.

METHODS: This analysis was based on data of the cluster randomized controlled DelpHi-MV trial. The intervention group received CDCM, comprising a comprehensive needs assessment and individualized interventions by dementia-specific qualified nurses over 6 months. The control group received usual care. Main outcomes were neuropsychiatric symptoms (NPI), caregiver burden (BIZA-D), health-related quality of life (SF-12), antidementia drug treatment, and cost-effectiveness (incremental cost/quality-adjusted life year (QALY)) over 36 months. Outcomes between groups were compared using multivariate regression models adjusted for baseline scores.

RESULTS: A total of 308 patients, of whom 221 received CDCM (mean age, 80.1 years; 64.3% women) and 87 received usual care (mean age, 79.2 years; 57.5% women), were included in the clinical effectiveness analyses, and 428 (303 CDCM, 125 usual care) were included in the cost-effectiveness analysis. Participants receiving CDCM showed significantly fewer neuropsychiatric symptoms (adjusted mean difference (AMD, NPI score), −10.26 [CI^95%, −16.95 - −3.58]; P=0.003), better mental health (AMD (SF-12), 2.26 [CI^95%, 0.31 - 4.21]; P=0.02), and lower caregiver burden (AMD (BIZA-D), −0.59 [CI^95%, −0.81 - −0.37]; P<0.001) and were more likely to take antidementia drugs (adjusted odds ratio, 1.91 [CI^95%, 0.96 - 3.77]; P=0.07) compared with usual care participants after 36 months. The CDCM group gained QALYs (0.137 [CI^95%, 0.000 - 0.274]; P=0.049) but had no significant increase in costs (437€ [−5,438€ - 6,313€]; P=0.87), resulting in a cost-effectiveness ratio of 3,186€/QALY. Cost-effectiveness was significantly better for patients living alone than for those living with a caregiver (47,538€/QALY).

CONCLUSIONS: CDCM was associated with improved patient, caregiver, and health system–relevant outcomes over 36 months beyond the intervention period. Therefore, it should become a health policy priority to initiate translation of CDCM into routine care.