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Improving primary care based post-diagnostic support for people living with dementia and carers: Developing a complex intervention using the Theory of Change

Bamford, Claire; Wilcock, Jane; Brunskill, Greta; Wheatley, Alison; Harrison Dening, Karen; Manthorpe, Jill; Allan, Louise; ... PriDem study team; + view all (2023) Improving primary care based post-diagnostic support for people living with dementia and carers: Developing a complex intervention using the Theory of Change. PLoS One , 18 (5) , Article e0283818. 10.1371/journal.pone.0283818. Green open access

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Abstract

BACKGROUND: The need to improve support following a diagnosis of dementia is widely recognised, but it is unclear how this can best be achieved within UK health and social care systems. A task-shared and task-shifted approach has been recommended, but there is limited guidance on how to achieve this in practice. As part of a programme of research, we developed an intervention to enhance the role of primary care in post-diagnostic care and support for people living with dementia and carers. METHODS: We used the Theory of Change to develop a complex intervention informed by initial literature reviews and qualitative work. The intervention was developed through an iterative series of workshops, meetings and task groups with a range of stakeholders, including the multidisciplinary project team, people living with dementia and carers, service managers, frontline practitioners, and commissioners. RESULTS: 142 participants contributed to intervention development through face-to-face or virtual meetings. The intervention comprises three complementary strands of work focusing on: developing systems, delivering tailored care and support, and building capacity and capability. Clinical dementia leads, based in primary care networks, will facilitate the intervention providing tailored expertise and support. CONCLUSION: The Theory of Change proved useful in providing structure and engaging stakeholders. The process was challenging, took longer and was less participative than intended due to restrictions caused by the COVID-19 pandemic. We will next conduct a feasibility and implementation study to explore whether the intervention can be successfully delivered within primary care. If successful, the intervention offers practical strategies for delivering a task-shared and task-shifted approach to post-diagnostic support that could be adapted for similar health and social care contexts internationally.

Type: Article
Title: Improving primary care based post-diagnostic support for people living with dementia and carers: Developing a complex intervention using the Theory of Change
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0283818
Publisher version: https://doi.org/10.1371/journal.pone.0283818
Language: English
Additional information: © 2023 Bamford et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Humans, Caregivers, Pandemics, Dementia, COVID-19, Primary Health Care, COVID-19 Testing
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10169476
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