Clinical trial NCT00866099: Dementia Early Recognition and Response in Primary Care
Official title: Evidence-based Interventions In Dementia EVIDEM-ED: Early Recognition and Response in Primary Care
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
PHASE3
Conditions: Dementia
Keywords: Dementia
primary care
early diagnosis
psychosocial interventions
cholinesterase inhibitors
Lead sponsor: University College, London
Sponsor class: OTHER
Collaborators: name: National Institute for Health Research, United Kingdom
name: Central and North West London NHS Foundation Trust
name: King's College London
name: University of Hertfordshire
name: St George's, University of London
name: London School of Economics and Political Science
name: Imperial College London
First posted: 2009-03-20
Enrollment: 125
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this study is to develop and test an educational intervention for dementia in primary care, combining timely diagnosis, psychosocial support around the period of diagnosis and management concordant with guidelines.

Detailed description: Dementia presents many challenges for primary care. Early diagnosis is important as this allows those with dementia and their family care networks to engage with support services and plan for the future. These actions can relieve the significant psychological distress that people with dementia and close supporters may experience , and provide knowledge about the availability of medical and psycho-social support that can improved functioning and morale

The main efforts to improve the identification and diagnosis of dementia should logically be targeted at primary care as this is the first point of contact for most individuals and their carers when faced with experiences of 'ill health'. There is, however, evidence that dementia remains under-detected and sub-optimally managed in general practice . An educational intervention that could enhance clinical practice, improving the skills of practitioners in the recognition of and response to dementia syndromes, could therefore be beneficial to people with dementia and their families, and potentially to health and social services.

Eligibility criteria: Inclusion Criteria:

* Patients with memory or other cognitive impairments suggestive of dementia syndrome
* those with a formal diagnosis of dementia, of any type.

Exclusion Criteria:

* Patients and carers who are already involved in concurrent research
* If the key professional feels that an approach to the person with dementia or their carer would be inappropriate, for example the dementia is very severe, or that an approach may increase distress
* and any other important reason that the key professional may have for why the person with dementia or their carer should not be contacted.

Primary outcomes:
measure: An increase in the proportion of patients with dementia receiving two dementia reviews per year, from 20% to 50%
timeFrame: twelve month follow up
Secondary outcomes:
measure: quality of life, met and unmet need in carers and/or people with dementia
timeFrame: twelve month follow up
measure: documented concordance with intervention recommendations on recording disclosure decisions & consequences
timeFrame: twelve month follow up
measure: documented concordance with screening for depression
timeFrame: twelve month follow up
measure: documented concordance with referral to social services
timeFrame: twelve month follow up
measure: documented concordance with informing people with dementia and their carers about relevant local voluntary organisations
timeFrame: twelve month follow up
measure: documented concordance with provision of legal information
timeFrame: twelve month follow up
measure: documented concordance with shared management of cholinesterase inhibitor medication
timeFrame: twelve month follow up
Other outcomes:
Locations:
city: London
country: United Kingdom
facility: Department of Primary Care and Population Health
state: England
city: London
country: United Kingdom
facility: University College London
state: Greater London
Study officials:
affiliation: University College, London
name: Jane Wilcock, MA(hons) MSc
role: PRINCIPAL_INVESTIGATOR
References:
citation: Wilcock J, Iliffe S, Griffin M, Jain P, Thune-Boyle I, Lefford F, Rapp D. Tailored educational intervention for primary care to improve the management of dementia: the EVIDEM-ED cluster randomized controlled trial. Trials. 2013 Nov 20;14:397. doi: 10.1186/1745-6215-14-397.
citation: Iliffe S, Wilcock J, Griffin M, Jain P, Thune-Boyle I, Koch T, Lefford F. 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). Trials. 2010 Feb 10;11:13. doi: 10.1186/1745-6215-11-13.