Articles

cabecera Newsletter 2

Contents:

Editorial:

After one and a half years of fruitful work, the ALCOVE joint action initiative is approaching the final stages of the project.

In this busy period, all work packages are finalizing their efforts. Completed deliverables are expected in the fields of good Practices in assessing dementia epidemiology, timely and unbiased diagnosis of dementia, appropriate care and treatment of the behavioral and psychological symptoms associated with dementia, and improvement in the rights of people living with dementia. All these efforts will converge in the preparation of the ALCOVE toolbox, which aims to be a powerful armamentarium for public health care with its special focus on good practice recommendations for a reduction in the inappropriate use of antipsychotics in dementia.

An important milestone in the ALCOVE two-year project was the second Steering Committee, which took place in Paris in April this year. With the participation of 70 attendees from 18 countries, including representatives of Health & Consumer Directorate General (DG Sanco) and Alzheimer Europe, the meeting conferred important impulses for ALCOVE cooperative work.

Several preliminary results stemming from ALCOVE's work are already available and were presented in peer-reviewed journals and international conferences including AAIC 2012 and NCG 2012. Perhaps the most notable occasion was in October at the Alzheimer Europe 2012 annual conference, where ALCOVE was presented in several instances, including a plenary keynote lecture.

We are highly encouraged in seeing that ALCOVE's progress has resulted in a strengthened collaboration between different EU member states with the creating of an ALCOVE network at the European level, fulfilling one of the original objectives of the project. Moreover, ALCOVE's actions are already well perceived by other European initiatives and networks on dementia, namely Alzheimer Europe, Joint Programme - Neurodegenerative Disease Research (JPND), European Alzheimer Disease Consortium (EADC) and European Innovative Partnership for Active and Healthy Ageing (EIP AHA).

Appreciation and acceptance of ALCOVE's work was underlined with the signing of the Declaration of Intention between ALCOVE and the Alzheimer Europe organization on collaboration on Alzheimer's disease and related dementias, at the 2nd ALCOVE Steering Committee.  
The ultimate tool for sharing ALCOVE conclusions and acquired knowledge will be the Final Event, which is scheduled for March 2013 in Paris. At this occasion, ALCOVE will present its toolbox which will include recommendations and methodologies prepared for implementation in European public health actions with the specific goal of reducing antipsychotic use.

Rostislav Skrabana PHD1, Michal Novak MD PHD1, Petr Novak1 MD PHD & ALCOVE Executive Board
(1) Monitoring & evaluation of the joint action Alcove, NIUSAV.

 

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7 ALCOVE WORK PACKAGES

France - Haute Autorité de Santé - Coordination
(Armelle Leperre-Desplanques, Nathalie Riolacci)
Spain – Instituto de Salud Carlos III
(Carlos Segovia, Tomas Peña)
Slovakia – Institute of Immunology
(Michael Novak, Rostislav Skrabana)
Italy – Istituto Superiore di Sanità
(Nicola Vanacore, Angela Giusti)
UK – Department of Health
(Dawn Brooker, Karim Saad)
Finland – National Institute for Health and Welfare
(Harriet Finne-Soveri, Matti Makela)
Belgium – King Baudouin Foundation
(Bénédicte Gombault, Gerrit Rauws)

European Union Joint Action ALCOVE (Alzheimer COoperative Valuation in Europe) partners

Belgium [King Baudouin Foundation, WP7 Leader]; Cyprus [Mental Health Services, Ministry of Health*]; Czech Republic [Ceska Alzheimerovska Spolecnost*]; France [Haute Autorité de Santé, WP1 leader, Coordinator; Assistance Publique-Hôpitaux de Paris, Espace Ethique; Institut National de la Santé et de la Recherche Médicale]; Finland [Institute of Health and Welfare, WP6 Leader]; Greece [Athens Association of Alzheimer's Disease and Related Disorders]; Hungary [Szegedi Tudomanyegyetem*]; Italy [Istituto Superiore di Sanità, WP4 leader, Ministry of Health, Prevention Directorate; Università degli Studi di Brescia]; Latvia [Riga Center of Psychiatry and Addiction Disorders]; Lithuania [Vilniaus Universiteto Medicinos Fakulteto*; Lietuvos Respublikos Sveikatos Apsaugos Ministerija*; Lithuanian University of Health Sciences]; Luxemburg [Ministère de la Famille et de l'Intégration*; Ministère de la Santé*]; Malta [Ministeru tas-Sahha, l-Anzjani u l-Kura fil-Kommunitta*]; Netherlands [Ministry of Health, Welfare and Sport*]; Norway [Ministry of Health and Care Services*]; Portugal [Coordenação Nacional de Saude Mental, Alto Comissariado para a Saude, Ministerio da Saude*]; Slovakia [Institute of Neuroimmunology, WP3 leader, Slovak Academy of Sciences; Ministerstvo Skolstva Slovenskej Republiky*]; Spain [Instituto de Salud Carlos III, WP2 Leader; Spanish Ministry of Health*; Fundacion Vasca de Innovacion e Investigacion Sanitarias]; Sweden [Karolinska Institutet]; UK [Department of Health, WP5 Leader; University of Stirling, Dementia Services Development Centre*].
* An asterisk indicates a Collaborative Partner, whose participation is on a voluntary basis.  All other names indicate Associated Partners, who receive financial support from the European Commission.

Summary of ALCOVE's Goals & Approaches

The goal of the ALCOVE- Joint Action is to reply to the following strategic questions in order to guide public health decisions in EU Member States.
•    How to improve data for better knowledge about dementia prevalence?
•    How to improve access to a dementia diagnosis and, in the process, to the appropriate care as early as possible?
•    How to improve care for people living with dementia and particularly those exhibiting the Behavioral and Psychological Symptoms of Dementia (BPSD)?
•    How to improve the rights of people with dementia regarding advance declarations of will and competence assessments?
The appropriate use of antipsychotics in this vulnerable population has been chosen as a common ground for the 4 core questions and as a guide to support the implementation of good practices in the field of risk prevention.

Based on the analyses and the answers to the four main questions, attained through the combination of literature searches, and the analyses of evidence and assessed practices or systems, ALCOVE will be able to both identify (a) the systems or practices devoted to dementia in place in the different European Union Member States, including how much they differ or vary from one another; and (b) the good practices and support systems which could be promoted at the European level.

 

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To know more, please see the article:

Sharing knowledge to advance healthcare policies in Europe for people living with dementia and their carers: the ALCOVE* project. Arch Public Health. 2012 Aug 28;70(1):21. Barr C, Riolacci N, Galbraith M, Leperre-Desplanques A. and the ALCOVE group.

 

 

 

ALCOVE preliminary results


•    That currently there is a discrepancy between the observed rate of prevalence in the national health systems, when this data is available, and the observed rate in cohorts. An updated mapping of different sources such as national insurance databases, registries, cohorts, surveys and recommendations to improve the quality and coherence of data collection could contribute to a better knowledge of the prevalence of Alzheimer's disease and related dementia, which is crucial in the construction of relevant strategies.

•    That Alzheimer's disease and related dementia are under-diagnosed all across European Union Member States. At this stage, improving diagnosis quality means making a timely diagnosis of the disease. Several European countries have already been working with memory centers for 10 years and the first appraisals of their effectiveness are now available.

•    That delivering better care in the treatment of BPSD is a shared and high level priority. BPSD is a large burden for daily carers and health professionals, so much so that it is a major reason behind early institutionalization and/or the prescribing of antipsychotics. Currently, new non-pharmaceutical interventions are being implemented in an effort to reduce BPSD and their consequences, such as targeted care techniques and psychological and environmental interventions. The assessment of these non-pharmaceutical approaches is still on-going.

•    Various and heterogeneous legal dispositions for people living with dementia are available in European Union Member States. An important question is how to find a better balance between preserving autonomy while legally protecting the individual (driving license, testamentary will). Health professionals need dedicated information and training on good practices for competence assessment in people living with dementia.

•    As the culmination of the project, ALCOVE will provide information on the exposure of patients living with dementia to antipsychotics in Europe and an evaluation of the existing antipsychotics risk reduction strategies for people living with dementia.

To know more, please see the article:
Sharing knowledge to advance healthcare policies in Europe for people living with dementia and their carers: the ALCOVE* project. Arch Public Health. 2012 Aug 28;70(1):21. Barr C, Riolacci N, Galbraith M, Leperre-Desplanques A. and the ALCOVE group.

ALCOVE news

ALCOVE is a network which is made up of representatives from European Member States in the framework of a public health mission.

Exchanges with other European networks dedicated to dementia are crucial for the awareness of best practices and solutions for the improvement of care quality in dementia.  

In this perspective, a letter of intent was signed between ALCOVE and ALZHEIMER EUROPE on April 11, 2012 so that the two networks can share their respective expertise and information while maintaining their individual missions. ALCOVE's preliminary results were presented at the Alzheimer Europe Conference in Vienna (October 4-6, 2012)

ALCOVE participated in initial meetings concerning the European initiative on Active and Healthy Ageing (EIP AHA) in April 2012 and began expressing its interest in working on future EIP AHA actions. Due to its expected impact on health systems and society, dementia represents a serious threat to medical-social systems and intergenerational solidarity. At the same time, the threat of dementia is an opportunity to reform and to innovate, especially in terms of technology, and could lead to growth once the needs of the population have been identified and correctly understood by the market.

ALCOVE's project coordinator was invited to write the editorial for the September 2012 edition of the Health EU Newsletter, which was devoted to World Alzheimer Day. (http://ec.europa.eu/health-eu/newsletter/96/newsletter_en.htm).

ALCOVE participated in the WHO's conference in London entitled "Developing a Person-Centered Model of Care for the Patient with Dementia (November 26-27).  Currently, ALCOVE is pursuing its exchanges with ALZHEIMER EUROPE, the World Health Organization, and the European Commission.

For further news and information: http://www.alcove-project.eu/

Next 6 months

ALCOVE is now organizing the ALCOVE Final Event scheduled for March 28, 2013 in Paris. ALCOVE's 19 European countries will present their conclusions with knowledge that could benefit each Member State along with options to improve health policy for dementia.

ALCOVE will present its Toolbox.  This information-exchange platform will include tools & feedback which will facilitate benchmarking and the implementation of public health actions including antipsychotic risk prevention.

 

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About this Newsletter

ALCOVE Newsletter is an electronic bulletin edited by the Health Institute Carlos III of Spain.
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