BMJ Open (Jul 2024)

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

  • ,
  • 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

DOI
https://doi.org/10.1136/bmjopen-2023-083175
Journal volume & issue
Vol. 14, no. 7

Abstract

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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.