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Griffiths S, Spencer E, Flanagan K, O'Keeffe A, Hunter R, Wiegand M, D'Andrea F, Benjamin L, Poole M, Hagan AJ, Brar M, Wilcock J, Walters KR, Robinson L, Rait G, Burns A, Evans E, King D, Knapp M, Lewins RD, Banerjee S, Manthorpe J, Allen L, Tucker S, Wittenberg R. Evaluating a model of best practice in primary care led post-diagnostic dementia care: feasibility and acceptability findings from the PriDem study. BMJ Open 2024; 14:e083175. [PMID: 39002959 PMCID: PMC11255409 DOI: 10.1136/bmjopen-2023-083175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 06/24/2024] [Indexed: 07/15/2024] Open
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.
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Affiliation(s)
- Sarah Griffiths
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
| | - Emily Spencer
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
| | - Katie Flanagan
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
| | - Aidan O'Keeffe
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
| | - Rachael Hunter
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
| | | | - Federica D'Andrea
- School of Biomedical Sciences, University of West London, London, UK
| | - Lewis Benjamin
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
| | - Marie Poole
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Alexander James Hagan
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - M Brar
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Jane Wilcock
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
| | - Kate R Walters
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
| | - Louise Robinson
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Greta Rait
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
| | - on behalf of the PriDem Study Team
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Alistair Burns
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Emily Evans
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Derek King
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Martin Knapp
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Revd Doug Lewins
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Sube Banerjee
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Jill Manthorpe
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Allen
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Sue Tucker
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Raphael Wittenberg
- Research Department of Population Health and Primary Care, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
- PRIMENT Clinical Trials Unit, UCL, London, UK
- Applied Health Research, Institute of Epidemiology & Health, Faculty of Population Health Sciences, UCL, London, UK
- Department of Statistical Science, UCL, London, UK
- School of Biomedical Sciences, University of West London, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
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