The Primary Care - Dementia Assessment and Treatment Algorithm (PC-DATA)
Alzheimer's disease (AD) and related forms of dementia currently affect over 400,000 individuals in Canada and the numbers of community dwelling older adults with AD is rapidly growing. AD is associated with over $15 billion annually in care costs. Most individuals with AD are under the care of primary care providers (PCPs) including family physicians and primary care nurses. The evaluation and management of AD is challenging for PCPs and the quality of care provided to older adults with AD by PCP could be improved which would optimize outcomes for this vulnerable population. Provision of quality care to older adults with AD involves implementation of best practices as outlined in guidelines such as the Canadian Consensus Conference Guidelines on the Diagnosis and Treatment of Dementia. Utilizing a group of dementia researchers, PCPs, other knowledge users, and individuals affected by AD, this project will develop practical, clinically relevant resources for primary care physicians and nurses to aid in the evaluation of older adults with AD. A knowledge tool, the Primary Care - Dementia Assessment and Treatment Algorithm (DATA Tool) will be introduced into several primary care settings in Ontario using educational sessions with PCP with additional support from internet resource and a dementia care manager. The quality of dementia care provided to older adults newly diagnosed with AD will be assessed in the three years preceding the intervention compared to the year following the implementation. This project will also describe the process of knowledge exchange with PCPs, including potential barriers and facilitators of knowledge uptake and examine if the care provided during the intervention was patient-centred through interviews with patients and caregivers.
- Develop knowledge tools to facilitate assessment and treatment of AD by PCPs based on best evidence;
- Transfer these knowledge tools into a variety of primary care settings in Ontario; and,
- Evaluate the effects of this intervention on dementia quality of care, PCP application of knowledge, and the patient-centeredness of care.
|Study Design:||Intervention Model: Single Group Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
|Official Title:||A Study Evaluating the Effects of a Primary Care - Dementia Assessment Treatment Algorithm on the Quality of Care Provided to Older Adults With Dementia in Primary Care Settings|
- Change in number of dementia care process quality indicators achieved. [ Time Frame: 1 year following implementation ]The evaluation of quality indicators (QI) using chart audit data will be undertaken following initial assessment of dementia will be used to assess the quality of care provided to individuals with dementia. The change in number of QI satisfied following the intervention will be compared to a historical group of individuals assessed for dementia by each PCP in the 3 years preceding the intervention.
- Impact on learning and knowledge application [ Time Frame: Approximately 9 months following intervention ]Qualitative interviews with family physicians and interprofessional primary care professional will be conducted using a grounded theory design will be conducted with primary care providers to identify key conceptual, contextual and process elements involved in the exchange and application of dementia-specific knowledge in the primary care context.
- Client-centred care [ Time Frame: Approximately 9 months following intervention ]Interviews will be conducted with patients and careviers to seek to identify key elements of patient-centred care.
|Study Start Date:||March 2012|
|Study Completion Date:||May 2016|
|Primary Completion Date:||December 2015 (Final data collection date for primary outcome measure)|
Other: PC-DATA tool
Please refer to this study by its ClinicalTrials.gov identifier: NCT01548053
|Kingston, Ontario, Canada, K7L 3N6|
|Principal Investigator:||Dallas P Seitz, MD||Queen's University|