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

Griffiths, Sarah; Spencer, Emily; Flanagan, Katie; O'Keeffe, Aidan; Hunter, Rachael; Wiegand, Martin; D'Andrea, Federica; Benjamin, Lewis; Poole, Marie; Hagan, Alexander James; Brar, M.; Wilcock, Jane; Walters, Kate R.; Robinson, Louise; Rait, Greta

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 carers Intervention: 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.

Citation

Griffiths, S., Spencer, E., Flanagan, K., O'Keeffe, A., Hunter, R., Wiegand, M., D'Andrea, F., Benjamin, L., Poole, M., Hagan, A. J., Brar, M., Wilcock, J., Walters, K. R., Robinson, L., & Rait, G. (2024). Evaluating a model of best practice in primary care led post-diagnostic dementia care: feasibility and acceptability findings from the PriDem study. BMJ Open, 14(7), Article e083175. https://doi.org/10.1136/bmjopen-2023-083175

• Journal Article Type: Article
• Acceptance Date: Jun 24, 2024
• Online Publication Date: Jul 13, 2024
• Publication Date: 2024-07
• Deposit Date: Jul 4, 2024
• Publicly Available Date: Jul 13, 2024
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 7
• Article Number: e083175
• DOI: https://doi.org/10.1136/bmjopen-2023-083175
• Keywords: primary care, feasibility studies, dementia
• Public URL: https://nottingham-repository.worktribe.com/output/36872691
• Publisher URL: https://bmjopen.bmj.com/content/14/7/e083175.abstract