Implementing the Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention: mixed-method process evaluation alongside a pragmatic randomised trial Aging and Mental Health

Chester, Helen; Beresford, Rebecca; Clarkson, Paul; Entwistle, Charlotte; Gillan, Vincent; Hughes, Jane; Orrell, Martin; Pitts, Rosa; Russell, Ian; Symonds, Eileen; Challis, David

Abstract

Objectives: The DESCANT (Dementia Early Stage Cognitive Aids New Trial) intervention provided a personalised care package designed to improve the cognitive abilities, function and well-being of people with early-stage dementia and their carers, by providing a range of memory aids, together with appropriate training and support. This sub-study aimed to assess implementation and identify contextual factors potentially associated with participant outcomes.

Method: A mixed-methods approach was adopted alongside the pragmatic randomised trial. Data were obtained from intervention records and interviews with five dementia support practitioners across seven National Health Service Trusts in England and Wales. A reporting framework was constructed from available literature and data assessed by descriptive statistics and thematic analysis.

Results: Participation and engagement was high with 126 out of 128 participants completing the intervention with packages tailored to individual participants. Misplacing items and poor orientation to date and time were common areas of need. Memory aids frequently supplied included orientation clocks (91%), whiteboards (60%), calendars (43%) and notebooks (32%), plus bespoke items. Intervention duration and timing were broadly consistent with expectations. Variation reflected participants’ needs, circumstances and preferences. Qualitative findings suggested a potentially positive impact on the well-being of people with dementia and their carers. Issues associated with successful roll-out of the intervention are explored in the discussion.

Conclusion: Successful implementation increased confidence in future findings of the randomised trial. Depending on these, DESCANT may prove a scalable intervention with potential to improve the function and quality of life of people with dementia and their carers.

Citation

Chester, H., Beresford, R., Clarkson, P., Entwistle, C., Gillan, V., Hughes, J., …Challis, D. (2022). Implementing the Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention: mixed-method process evaluation alongside a pragmatic randomised trial Aging and Mental Health. Aging and Mental Health, 26(4), 667-678. https://doi.org/10.1080/13607863.2020.1870204

• Journal Article Type: Article
• Acceptance Date: Dec 24, 2020
• Online Publication Date: Jan 13, 2021
• Publication Date: 2022
• Deposit Date: Jan 8, 2021
• Publicly Available Date: Jan 14, 2022
• Journal: Aging and Mental Health
• Print ISSN: 1360-7863
• Publisher: Routledge
• Peer Reviewed: Peer Reviewed
• Volume: 26
• Issue: 4
• Pages: 667-678
• DOI: https://doi.org/10.1080/13607863.2020.1870204
• Keywords: Dementia, Pragmatic randomised trial, Intervention, Process evaluation, Mixed methods
• Public URL: https://nottingham-repository.worktribe.com/output/5205701
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/13607863.2020.1870204
• Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Aging and Mental Health on 13 Jan 2021, available online: http://www.tandfonline.com/10.1080/13607863.2020.1870204