Family Medicine, McGill University, Montreal, Quebec, Canada
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
BMJ Open. 2020 May 15;10(5):e035916. doi: 10.1136/bmjopen-2019-035916.
Dementia is on the rise in Canada and globally. Ensuring accessibility to diagnosis, treatment and management throughout the course of the disease is a very significant problem worldwide. In order to provide comprehensive care to patients and their caregivers, enhancing primary care-based dementia care is seen as the way forward. In many Canadian provinces various collaborative care models (collCMs) anchored in primary care to improve dementia care have been developed and implemented. The overall objective of our research programme is to identify key factors for the successful implementation of collCMs, and to facilitate dissemination and scale-up of dementia best practices.
We will use a convergent mixed-methods design. An observational study using chart review (2014-2016) and questionnaires (2014-2018; repeated in 2020) will measure application of guidelines and implementation of collCMs. This study will be complemented with a qualitative descriptive study using interviews (2017-2020) conducted in parallel. Quantitative and qualitative results will be further integrated using a matrix representing sites and findings. An integrated knowledge exchange strategy will ensure uptake by principal stakeholders throughout the research.
Our study has been approved by all relevant ethics committees. Our dissemination plan follows an integrated knowledge transfer strategy using provincial, national and international councils. We will present the results individually to the clinical sites and then to these councils. Our research will be the first provincial and cross jurisdictional evaluation of primary care models for patients living with dementia, providing evidence on the ongoing debate on the respective role of clinicians in primary care and specialists in caring for patients with dementia.
痴呆症在加拿大和全球范围内呈上升趋势。确保在疾病过程中能够获得诊断、治疗和管理，是一个全球性的重大问题。为了为患者及其护理人员提供全面的护理，加强以初级保健为基础的痴呆症护理被视为未来的发展方向。在加拿大的许多省份，已经开发和实施了各种以初级保健为基础的合作护理模式（collCM），以改善痴呆症的护理。我们的研究计划的总体目标是确定成功实施 collCM 的关键因素，并促进痴呆症最佳实践的传播和扩大。
我们将采用收敛混合方法设计。一项观察性研究将使用图表审查（2014-2016 年）和问卷调查（2014-2018 年；2020 年重复）来衡量指南的应用和 collCM 的实施情况。这项研究将辅以使用访谈（2017-2020 年）进行的定性描述性研究。使用矩阵表示站点和发现，将进一步整合定量和定性结果。综合知识交流策略将确保主要利益攸关方在整个研究过程中的参与。
我们的研究已经得到了所有相关伦理委员会的批准。我们的传播计划遵循一个综合的知识转移策略，利用省、国家和国际理事会。我们将逐个向临床站点介绍结果，然后向这些理事会介绍。我们的研究将是对初级保健模式的第一个省级和跨司法管辖区的评估，为正在进行的关于临床医生在初级保健和专家在照顾痴呆症患者方面各自作用的辩论提供证据。
