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Evaluating a model of best practice in primary care led post-diagnostic dementia care: feasibility and acceptability findings from the PriDem study

Authors :
Rachael Hunter
Louise Robinson
Greta Rait
Kate R Walters
Marie Poole
Jill Manthorpe
Jane Wilcock
Martin Knapp
Sube Banerjee
Derek King
Louise Allen
Katie Flanagan
Alistair Burns
Raphael Wittenberg
Emily Evans
Sarah Griffiths
Sue Tucker
M Brar
Emily Spencer
Martin Wiegand
Federica D'Andrea
Aidan O'Keeffe
Revd Doug Lewins
Lewis Benjamin
Alexander James Hagan
Source :
BMJ Open, Vol 14, Iss 7 (2024)
Publication Year :
2024
Publisher :
BMJ Publishing Group, 2024.

Abstract

Objectives To evaluate the feasibility and acceptability of a primary care-based intervention for improving post-diagnostic dementia care and support (PriDem), and implementation study procedures.Design A non-randomised, mixed methods, feasibility study.Setting Seven general practices from four primary care networks (PCNs) in the Northeast and Southeast of England.Participants We aimed to recruit 80 people with dementia (PWD) and 66 carersIntervention Clinical Dementia Leads delivered a 12-month intervention in participating PCNs, to develop care systems, build staff capacity and capability, and deliver tailored care and support to PWD and carers.Outcomes Recruitment and retention rates were measured. A mixed methods process evaluation evaluated feasibility and acceptability of the intervention and study procedures. Using electronic care records, researchers extracted service use data and undertook a dementia care plan audit, preintervention and postintervention, assessing feasibility of measuring the primary implementation outcome: adoption of personalised care planning by participating general practices. Participants completed quality of life, and service use measures at baseline, 4 and 9 months.Results 60 PWD (75% of recruitment target) and 51 carers (77% of recruitment target) were recruited from seven general practices across four PCNs. Retention rate at 9 months was 70.0% of PWD and 76.5% of carers. The recruitment approach showed potential for including under-represented groups within dementia. Despite implementation challenges, the intervention was feasible and acceptable, and showed early signs of sustainability. Study procedures were feasible and accessible, although researcher capacity was crucial. Participants needed time and support to engage with the study. Care plan audit procedures were feasible and acceptable.Conclusions The PriDem model is an acceptable and feasible intervention. A definitive study is warranted to fully inform dementia care policy and personalised dementia care planning guidance. Successful strategies to support inclusion of PWD and their carers in future research were developed.Trial registration number ISRCTN11677384.

Subjects

Subjects :
Medicine

Details

Language :
English
ISSN :
20446055
Volume :
14
Issue :
7
Database :
Directory of Open Access Journals
Journal :
BMJ Open
Publication Type :
Academic Journal
Accession number :
edsdoj.836d6723a2344746b7d0b9850427effb
Document Type :
article
Full Text :
https://doi.org/10.1136/bmjopen-2023-083175