Organisational models designed to create connectivity, alignment and collaboration within and between the cure and care sectors are needed, and our study provides the evidence to support this approach. Our diagnostic intervention indeed lasted only a few weeks, but in our view, dementia care is a chain of services, starting with a short but comprehensive diagnostic phase resulting in a treatment plan that lasts throughout the course of the illness. Our intervention was merely the beginning of that chain, and we acknowledge that this is an ongoing process.
In contrast to McNulty et al, who found the results of our study modest, we value a difference of almost 10% between groups regarding health-related quality of life as substantial and clinically relevant, and higher than found in any pharmacological study in dementia so far.
The suggestion of McNulty et al to compare different types of services would be interesting, but the design of our study was not appropriate for such a reanalysis, as it would be subject to confounding by indication.
Nevertheless, McNulty et al raise the important point that dementia care needs an integrated approach on an ongoing basis, and we agree wholeheartedly.
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