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463 - Evaluating the Implementation of a Memory Clinic using the RE-AIM model. The experience of the “Memory and Neuropsychiatry Clinic” in Hospital del Salvador, Chile

Implementation of a Memory Clinic in Chile

Published online by Cambridge University Press:  04 November 2020

T. Leon
Affiliation:
Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile
L. Castro
Affiliation:
Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile
F. Mascayano
Affiliation:
Mailman School of Public Health, Columbia University, New York. U.S.A New York State Psychiatric Institute, New York, U.S.A
BA. Lawlor
Affiliation:
Global Brain Health Institute, Trinity College, Dublin, Ireland
A. Slachevsky*
Affiliation:
Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile Geroscience Center for Brain Health and Metabolism (GERO), University of Chile School of Medicine, Santiago, Chile Neurology Unit, Department of Medicine, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
*
Corresponding authors: Andrea Slachevsky [email protected]

Abstract

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The prevalence of dementia in Chile is 1.06 %, meaning that over 200,000 people are affected. In 2017, the Ministry of Health launched the National Plan of Dementia, which proposed establishing a range of health-care services from primary care to Memory Units (MU).

MUs have emerged as a new health care service composed of multidisciplinary teams with the goal of improving diagnosis and management of dementia patients.

The creation and implementation of a MU should take into consideration the organization of a particular healthcare system. In this context, the evaluation of a Chilean MU might provide information for the standardization and replication of such a health service on a regional basis.

The objective of this paper was to evaluate the implementation processes of a MU using the RE-AIM model, a multi-component model aimed to assist the evaluation of the implementation of ongoing programs.

Regarding “R” (Reach): from March 2018 up to June 2019, a total of 510 patients were referred and assessed at the Hospital del Salvador. Most patients came from primary care (51.9 %) and from outpatient services at the Hospital (39.2 %), particularly from the Neurology (63.3%) and Psychiatry (16.0 %) departments. We estimated that the MU assessed 5.39% of dementia patients living in the area of referral.

In relationship with “E” (Effectiveness): of patients evaluated by the MU, 60 (11%) were discharged. Of these, 41 (66%) were referred to primary health care, 9 (17%) to other outpatient services, 6 (10%) to a specialized mental health care center, and 4 (7%) to a daycare center.

Due to the short lifespan of our MU, no other RE-AIM dimensions could be evaluated yet.

This was the first evaluation of the implementation of a MU in Chile as part of the Chilean Dementia Plan. It showed that it is possible to implement a MU in a Latin American country and improve access to dementia diagnosis, management, and treatment. Ongoing challenges include continuing to collect clinical data, creating research projects as part of the MU, and developing a MU protocol that can be adopted elsewhere in Chile and other Latin American countries.

Type
Abstract
Copyright
© International Psychogeriatric Association 2020

Footnotes

Acknowledgement: AS was partially supported by ANID/FONDEF/18I10113, the Inter-American Development Bank (IADB) and grants from the National Institutes of Health (R01 AG057234), Alzheimer’s Association, Rainwater Charitable Foundation, and Global Brain Health Institute.

The contents of this publication are solely the responsibility of the authors and do not represent the official views of the sponsors.