Navigating the future of Alzheimer's care in Ireland - a service model for disease-modifying therapies in small and medium-sized healthcare systems.

Leroi, I; Dolphin, H; Dinh, R; Foley, T; Kennelly, S; Kinchin, I; O'Caoimh, R; O'Dowd, S; O'Philbin, L; O'Reilly, S; Trepel, D; Timmons, S

Navigating the future of Alzheimer's care in Ireland - a service model for disease-modifying therapies in small and medium-sized healthcare systems.

Leroi, I Dolphin, H Dinh, R Foley, T Kennelly, S Kinchin, I

O'Caoimh, R O'Dowd, S O'Philbin, L O'Reilly, S Trepel, D Timmons, S

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Publisher:: BMC
Publication Type:: Journal Article
Citation:: BMC Health Serv Res, 2024, 24, (1), pp. 705
Issue Date:: 2024-06-05

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Field	Value	Language
dc.contributor.author	Leroi, I
dc.contributor.author	Dolphin, H
dc.contributor.author	Dinh, R
dc.contributor.author	Foley, T
dc.contributor.author	Kennelly, S
dc.contributor.author	Kinchin, I https://orcid.org/0000-0003-0133-2763
dc.contributor.author	O'Caoimh, R
dc.contributor.author	O'Dowd, S
dc.contributor.author	O'Philbin, L
dc.contributor.author	O'Reilly, S
dc.contributor.author	Trepel, D
dc.contributor.author	Timmons, S
dc.date.accessioned	2025-01-02T00:25:53Z
dc.date.available	2024-04-19
dc.date.available	2025-01-02T00:25:53Z
dc.date.issued	2024-06-05
dc.identifier.citation	BMC Health Serv Res, 2024, 24, (1), pp. 705
dc.identifier.issn	1472-6963
dc.identifier.issn	1472-6963
dc.identifier.uri	http://hdl.handle.net/10453/182775
dc.description.abstract	BACKGROUND: A new class of antibody-based drug therapy with the potential for disease modification is now available for Alzheimer's disease (AD). However, the complexity of drug eligibility, administration, cost, and safety of such disease modifying therapies (DMTs) necessitates adopting new treatment and care pathways. A working group was convened in Ireland to consider the implications of, and health system readiness for, DMTs for AD, and to describe a service model for the detection, diagnosis, and management of early AD in the Irish context, providing a template for similar small-medium sized healthcare systems. METHODS: A series of facilitated workshops with a multidisciplinary working group, including Patient and Public Involvement (PPI) members, were undertaken. This informed a series of recommendations for the implementation of new DMTs using an evidence-based conceptual framework for health system readiness based on [1] material resources and structures and [2] human and institutional relationships, values, and norms. RESULTS: We describe a hub-and-spoke model, which utilises the existing dementia care ecosystem as outlined in Ireland's Model of Care for Dementia, with Regional Specialist Memory Services (RSMS) acting as central hubs and Memory Assessment and Support Services (MASS) functioning as spokes for less central areas. We provide criteria for DMT referral, eligibility, administration, and ongoing monitoring. CONCLUSIONS: Healthcare systems worldwide are acknowledging the need for advanced clinical pathways for AD, driven by better diagnostics and the emergence of DMTs. Despite facing significant challenges in integrating DMTs into existing care models, the potential for overcoming challenges exists through increased funding, resources, and the development of a structured national treatment network, as proposed in Ireland's Model of Care for Dementia. This approach offers a replicable blueprint for other healthcare systems with similar scale and complexity.
dc.format	Electronic
dc.language	eng
dc.publisher	BMC
dc.relation.ispartof	BMC Health Serv Res
dc.relation.isbasedon	10.1186/s12913-024-11019-7
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	0807 Library and Information Studies, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Health Policy & Services
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4205 Nursing
dc.subject.classification	4206 Public health
dc.subject.mesh	Humans
dc.subject.mesh	Alzheimer Disease
dc.subject.mesh	Ireland
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Models, Organizational
dc.subject.mesh	Humans
dc.subject.mesh	Alzheimer Disease
dc.subject.mesh	Models, Organizational
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Ireland
dc.subject.mesh	Humans
dc.subject.mesh	Alzheimer Disease
dc.subject.mesh	Ireland
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Models, Organizational
dc.title	Navigating the future of Alzheimer's care in Ireland - a service model for disease-modifying therapies in small and medium-sized healthcare systems.
dc.type	Journal Article
utslib.citation.volume	24
utslib.location.activity	England
utslib.for	0807 Library and Information Studies
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/INSIGHT: Institute for Innovative Solutions for Well-being and Health/Centre for Health Economics Research and Evaluation (CHERE)
pubs.organisational-group	University of Technology Sydney/UTS Groups/Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT)
pubs.organisational-group	University of Technology Sydney/UTS Groups/INSIGHT: Institute for Innovative Solutions for Well-being and Health
pubs.organisational-group	University of Technology Sydney/UTS Groups/INSIGHT: Institute for Innovative Solutions for Well-being and Health/Centre for Health Economics Research and Evaluation (CHERE)/Centre for Health Economics Research and Evaluation (CHERE) Associate Members
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2025-01-02T00:25:52Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	24
utslib.citation.issue	1

Abstract:

BACKGROUND: A new class of antibody-based drug therapy with the potential for disease modification is now available for Alzheimer's disease (AD). However, the complexity of drug eligibility, administration, cost, and safety of such disease modifying therapies (DMTs) necessitates adopting new treatment and care pathways. A working group was convened in Ireland to consider the implications of, and health system readiness for, DMTs for AD, and to describe a service model for the detection, diagnosis, and management of early AD in the Irish context, providing a template for similar small-medium sized healthcare systems. METHODS: A series of facilitated workshops with a multidisciplinary working group, including Patient and Public Involvement (PPI) members, were undertaken. This informed a series of recommendations for the implementation of new DMTs using an evidence-based conceptual framework for health system readiness based on [1] material resources and structures and [2] human and institutional relationships, values, and norms. RESULTS: We describe a hub-and-spoke model, which utilises the existing dementia care ecosystem as outlined in Ireland's Model of Care for Dementia, with Regional Specialist Memory Services (RSMS) acting as central hubs and Memory Assessment and Support Services (MASS) functioning as spokes for less central areas. We provide criteria for DMT referral, eligibility, administration, and ongoing monitoring. CONCLUSIONS: Healthcare systems worldwide are acknowledging the need for advanced clinical pathways for AD, driven by better diagnostics and the emergence of DMTs. Despite facing significant challenges in integrating DMTs into existing care models, the potential for overcoming challenges exists through increased funding, resources, and the development of a structured national treatment network, as proposed in Ireland's Model of Care for Dementia. This approach offers a replicable blueprint for other healthcare systems with similar scale and complexity.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/182775