AUTHOR=Leon Tomas , Castro Loreto , Mascayano Franco , Lawlor Brian , Slachevsky Andrea 

TITLE=Evaluating a Memory Clinic Using the RE-AIM Model. The Experience of the “Memory and Neuropsychiatry Clinic” in Hospital Del Salvador, Chile

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.612416

DOI=10.3389/fneur.2021.612416

ISSN=1664-2295

ABSTRACT=The development of health care services for dementia is key to improving access to care and post-diagnostic support for people living with dementia.  Memory Units (MU) have emerged as a new health care service composed of multidisciplinary teams with the goal of improving diagnosis and/or management of dementia patients.

The main objective of this study was to describe and evaluate the Reach and Effectiveness of a MU in a public hospital in Chile, using the RE-AIM model, a multi-component model that allows for the evaluation of the implementation of ongoing health-care programs. 

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

With respect to “E” (Effectiveness): 419 patients are still being followed up at the MU. 91 patients (18%) were discharged. Of these, 55 (66%) were referred to primary health care, 28 (31%) to other outpatient services, 9 (10%) to a specialized mental health care center, and 9 (10%) to a daycare center. 

Due to the short period of time that the MU has been operating, no other RE-AIM dimensions could be evaluated at this juncture.

To our knowledge, this is the first implementation study of a MU in Latin America, and the first using the RE-AIM model. Although cultural differences worldwide might play a role in the lack of international guidelines, the publication of the experience of the first year of this MU in Chile could inform new countries about this process. Ongoing challenges include continuing to collect data to complement the RE-AIM evaluation and developing a MU protocol that can be adopted elsewhere in Chile and Latin America.

Further studies are needed to assess the benefits of a MU in comparison to regular care and to develop a model that assures continuity and coordination of care for people with dementia.