1 / 10

Evidence based interventions in dementia: the EVIDEM early diagnosis trial

Evidence based interventions in dementia: the EVIDEM early diagnosis trial. Steve Iliffe, Jane Wilcock, Mark Griffin, Priya Jane, Ingela Thuné- Boyle, Frances Lefford, David Rapp for the EVIDEM-ED project team. The problem. Early intervention can improve QOL and delay move to care home

lawrence-cleveland
Download Presentation

Evidence based interventions in dementia: the EVIDEM early diagnosis trial

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Evidence based interventions in dementia: the EVIDEM early diagnosis trial Steve Iliffe, Jane Wilcock, Mark Griffin, Priya Jane, Ingela Thuné- Boyle, Frances Lefford, David Rapp for the EVIDEM-ED project team

  2. The problem • Early intervention can improve QOL and delay move to care home • Late recognition, sub-optimal management in primary care • Modest success in increasing case finding, but not in improving management (Downs et al BMJ 2006) • Dementia diagnosis and review incentivised since 2006 ADI, London

  3. NIHR programme grant 2007-2012 • Research as a dialogue > expert activity • Adult learning, workplace-based • Collaborative reflection, team learning, problem-solving • Short-range interactions • Co-design Kernick D Wanted- new methodologies for health service research. Is complexity theory the answer? Family Practice 2006;23:385-390 Bate P & Robert G Toward more user-centric organisation development J ApplBehav Science 2007; 43:41 Hall J Professionalising action research – a meaningful strategy for modernising services? J Nurs Management 2006;14: 195-200 ADI, London

  4. Educational intervention • Self-diagnosis of learning needs • Semi-structured interview with 11 questions • Group discussion with facilitator & non-participant observer • Educational prescription • Tailored educational workshops in practices ADI, London

  5. Eleven questions How would you rate your current care for people with dementia and their carers? What grounds or criteria is your rating based on? After diagnosis, what follow-up do you provide to people with dementia and their carers? What do you think are the important quality markers in caring for people with dementia? (What would you want for yourself?) Is there anything in your current practice that you would like improve? ADI, London

  6. Educational prescription • Update diagnostic skills and review assessment tools • Develop a ‘shared care’ protocol for management of patients with dementia, with emphasis on global assessment of disease progression. • To learn how to manage BPSD problems as they arise • To find a way to discuss complex cases of patients with dementia (e.g. those living in ‘problem families’, isolated PWD with language barriers) Absent topics: Carers’ needs, MCA2005 ADI, London

  7. Pragmatic randomised control trial • Two arm trial: Educational workshops vs‘Normal care’ in 23 practices • Primary outcome: dementia reviews increase from one to two yearly • Secondary outcomes: concordance with management guidelines; knowledge, skills and attitudes; carer satisfaction • Before and after measures capture policy effects & Hawthorne effect • Between arm comparison captures intervention effect ADI, London

  8. Primary outcomes ADI, London

  9. Secondary outcomes (selected) ADI, London

  10. Thank you for listening This study has received financial support from the Department of Health National Institute for Health Research Programme Grants for Applied Research funding scheme. The views and opinions expressed therein do not necessarily reflect those of the Department of Health or the NIHR www.evidem.org.uk ADI, London

More Related