TY - JOUR
KW - Attitude of Health Personnel
KW - Caregivers/psychology
KW - Clinical Competence
KW - Decision Support Systems, Clinical
KW - Decision Support Techniques
KW - Dementia/diagnosis/psychology/therapy
KW - Early Diagnosis
KW - Education, Medical, Continuing
KW - England
KW - Evidence-Based Medicine
KW - Family Practice
KW - Guideline Adherence
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Physician's Practice Patterns
KW - Practice Guidelines as Topic
KW - Predictive Value of Tests
KW - Primary Health Care
KW - Quality of Life
KW - Research Design
KW - Stress, Psychological/etiology
KW - Treatment Outcome
AU - S. Iliffe
AU - J. Wilcock
AU - M. Griffin
AU - P. Jain
AU - I. Thune-Boyle
AU - T. Koch
AU - F. Lefford
A1 - 
AB - BACKGROUND: The National Dementia Strategy seeks to enhance general practitioners' diagnostic and management skills in dementia. Early diagnosis in dementia within primary care is important as this allows those with dementia and their family care networks to engage with support services and plan for the future. There is, however, evidence that dementia remains under-detected and sub-optimally managed in general practice. An earlier unblinded, cluster randomised controlled study tested the effectiveness of educational interventions in improving detection rates and management of dementia in primary care. In this original trial, a computer decision support system and practice-based educational workshops were effective in improving rates of detecting dementia although not in changing clinical management. The challenge therefore is to find methods of changing clinical management. Our aim in this new trial is to test a customised educational intervention developed for general practice, promoting both earlier diagnosis and concordance with management guidelines. DESIGN/METHOD: The customised educational intervention combines practice-based workshops and electronic support material. Its effectiveness will be tested in an unblinded cluster randomised controlled trial with a pre-post intervention design, with two arms; normal care versus the educational intervention. Twenty primary care practices have been recruited with the aim of gaining 200 patient participants. We will examine whether the intervention is effective, pragmatic and feasible within the primary care setting. Our primary outcome measure is an increase in the proportion of patients with dementia who receive at least two dementia-specific management reviews per year. We will also examine important secondary outcomes such as practice concordance with management guidelines and benefits to patients and carers in terms of quality of life and carer strain. DISCUSSION: The EVIDEM-ED trial builds on the earlier study but the intervention is different in that it is specifically customised to the educational needs of each practice. If this trial is successful it could have implications for the implementation of the National Dementia Strategy. TRIAL REGISTRATION: NCT00866099.
BT - Trials
C5 - Education & Workforce; HIT & Telehealth
CY - England
DO - 10.1186/1745-6215-11-13
JF - Trials
N2 - BACKGROUND: The National Dementia Strategy seeks to enhance general practitioners' diagnostic and management skills in dementia. Early diagnosis in dementia within primary care is important as this allows those with dementia and their family care networks to engage with support services and plan for the future. There is, however, evidence that dementia remains under-detected and sub-optimally managed in general practice. An earlier unblinded, cluster randomised controlled study tested the effectiveness of educational interventions in improving detection rates and management of dementia in primary care. In this original trial, a computer decision support system and practice-based educational workshops were effective in improving rates of detecting dementia although not in changing clinical management. The challenge therefore is to find methods of changing clinical management. Our aim in this new trial is to test a customised educational intervention developed for general practice, promoting both earlier diagnosis and concordance with management guidelines. DESIGN/METHOD: The customised educational intervention combines practice-based workshops and electronic support material. Its effectiveness will be tested in an unblinded cluster randomised controlled trial with a pre-post intervention design, with two arms; normal care versus the educational intervention. Twenty primary care practices have been recruited with the aim of gaining 200 patient participants. We will examine whether the intervention is effective, pragmatic and feasible within the primary care setting. Our primary outcome measure is an increase in the proportion of patients with dementia who receive at least two dementia-specific management reviews per year. We will also examine important secondary outcomes such as practice concordance with management guidelines and benefits to patients and carers in terms of quality of life and carer strain. DISCUSSION: The EVIDEM-ED trial builds on the earlier study but the intervention is different in that it is specifically customised to the educational needs of each practice. If this trial is successful it could have implications for the implementation of the National Dementia Strategy. TRIAL REGISTRATION: NCT00866099.
PP - England
PY - 2010
SN - 1745-6215; 1745-6215
SP - 13
T1 - Evidence-based interventions in dementia: A pragmatic cluster-randomised trial of an educational intervention to promote earlier recognition and response to dementia in primary care (EVIDEM-ED)
T2 - Trials
TI - Evidence-based interventions in dementia: A pragmatic cluster-randomised trial of an educational intervention to promote earlier recognition and response to dementia in primary care (EVIDEM-ED)
U1 - Education & Workforce; HIT & Telehealth
U2 - 20146803
U3 - 10.1186/1745-6215-11-13
VL - 11
VO - 1745-6215; 1745-6215
Y1 - 2010
ER -