Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK.
BMJ Open. 2024 Jul 13;14(7):e083175. doi: 10.1136/bmjopen-2023-083175.
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.
A non-randomised, mixed methods, feasibility study.
Seven general practices from four primary care networks (PCNs) in the Northeast and Southeast of England.
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.
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.
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.
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.
ISRCTN11677384.
评估基于初级保健的改善诊断后痴呆护理和支持（PriDem）干预措施的可行性和可接受性，并对实施研究程序进行评估。
一项非随机、混合方法的可行性研究。
英格兰东北部和东南部的四个初级保健网络中的 7 个普通实践。
我们旨在招募 80 名痴呆症患者（PWD）和 66 名照顾者。
临床痴呆领导在参与的初级保健网络中提供了为期 12 个月的干预措施，以发展护理系统、增强员工能力和能力，并为 PWD 和照顾者提供量身定制的护理和支持。
测量了招募和保留率。混合方法的过程评估评估了干预措施和研究程序的可行性和可接受性。研究人员使用电子护理记录提取服务使用数据，并进行了痴呆症护理计划审计，在干预前后进行，评估了参与的普通实践采用个性化护理计划的主要实施结果的可行性。参与者在基线、4 个月和 9 个月时完成了生活质量和服务使用的测量。
从四个初级保健网络中的七个普通实践中招募了 60 名 PWD（招募目标的 75%）和 51 名照顾者（招募目标的 77%）。9 个月时的保留率为 PWD 的 70.0%和照顾者的 76.5%。招募方法显示出将代表性不足的群体纳入痴呆症的潜力。尽管存在实施挑战，但该干预措施是可行和可接受的，并且显示出可持续性的早期迹象。研究程序是可行和可访问的，尽管研究人员的能力至关重要。参与者需要时间和支持来参与研究。护理计划审计程序是可行和可接受的。
PriDem 模型是一种可接受且可行的干预措施。需要进行一项确定性研究，以充分为痴呆症护理政策和个性化痴呆症护理计划指南提供信息。为支持将 PWD 及其照顾者纳入未来研究制定了成功的策略。
ISRCTN83340514。
