Integrated approach for optimization of treatment for multimorbid elderly patients with dementia

The CAREPATH project launched on 1st of July 2021, is a European Horizon 2020's project that proposes an ICT based solution for the optimization of clinical practice in the treatment and management of multimorbid patients with Mild Cognitive Impairment (MCI) or mild dementia (MD). CAREPATH project solution will target a more complex multimorbidity scenario and follows an integrated patient-centered approach, to develop a flexible and modular system to deliver an optimized care, adapted framework that allow increasing the independence and Quality of Life (QoL) of multimorbid patients with dementia.

CAREPATH project focuses on the enhancement of healthcare interventions for the management of conditions of elderly multimorbid patients, which present many challenges for Europe, as existing healthcare systems remain single-disease oriented. Multimorbidity increases with age and it is a key driver of healthcare costs and the sustainability of health systems worldwide. This situation becomes more complex, when multimorbidity is associated with dementia. There is no clear optimal healthcare pathway for multimorbid patients with dementia.

People with two or more chronic conditions, who are also suffering from dementia, tend to be at additional risk than those without dementia: a) multimorbidity can affect their dementia, leading to an acceleration of its progression, and b) dementia can worsen their multiple conditions, by hindering their effective management.

Statistics worldwide are supporting these observations:

  • 91.8% of people living with dementia are multimorbid:
  • 13.2% with one additional condition,
  • 33.8% with two or three additional conditions,
  • 27.8% with four or five additional conditions,
  • and 16.9% with six or more additional conditions.

Diabetes and heart disease are common co-morbidities, amongst people suffering with dementia. The experience of living with multiple diseases is extremely challenging for both patients and their family caregivers. For example, cognitive impairment affects a patient's capacity for self-management of multimorbidity, thus contributing to increasing rates of hospitalization. In the UK alone, between 45% and 58% of people living with dementia and one of diabetes, stroke or vision impairment, used hospital services at least once in a year, compared to a third without any of these conditions.

CAREPATH project proposes an Integrated Care Platform that jointly addresses multimorbidity, dementia and reduced substantial capacity and optimally manages healthcare interventions for its users (patients, informal caregiver, healthcare providers, etc.

The project will conduct a Technical Validation and Usability (TVU) study involving over 45 users and Clinical Investigation (CI) involving over 200 patients that will be conducted in four European countries (Spain, Romania, Germany, and UK). On the other hand, presenting guideline for Dementia/Multimorbidity that will be conceived for best healthcare delivery. In addition to that, CAREPATH project, will introduce a Health Economics Impact Assessment for healthcare cost effectiveness and care provision equalities.

Finally, The CAREPATH consortium is well-balanced both in terms of geographical spread 10 partners from six countries, The consortium consists of three categories of partners, two universities, four clinicals partners, one R&D Centre and four SMEs. The project is coordinated by the company ECLEXYS SAGL Switzerland.

Fraunhofer FIT is a member of the consortium and responsible mainly for collecting user requirements, conducting usability studies and designing a corresponding architecture. Furthermore, Fraunhofer FIT will develop and integrate the polypharmacy module of the CAREPATH platform.

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