Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol.
Wheat, H; Weston, L; Oh, TM; et al.Morgan-Trimmer, S; Ingram, W; Griffiths, S; Sheaff, R; Clarkson, P; Medina-Lara, A; Musicha, C; Spicer, S; Ukoumunne, O; Allgar, V; Creanor, S; Clark, M; Quinn, C; Gude, A; McCabe, R; Batool, S; Smith, L; Richards, D; Shafi, H; Warwick, B; Lasrado, R; Hussain, B; Jones, H; Dalkin, S; Bate, A; Sherriff, I; Robinson, L; Byng, R
Date: 12 July 2023
Article
Journal
BJGP Open
Publisher
Royal College of General Practitioners
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Abstract
BACKGROUND: Different dementia support roles exist but evidence is lacking on which aspects are best, for whom, and in what circumstances, and on their associated costs and benefits. Phase 1 of the Dementia PersonAlised Care Team programme (D-PACT) developed a post-diagnostic primary care-based intervention for people with dementia and ...
BACKGROUND: Different dementia support roles exist but evidence is lacking on which aspects are best, for whom, and in what circumstances, and on their associated costs and benefits. Phase 1 of the Dementia PersonAlised Care Team programme (D-PACT) developed a post-diagnostic primary care-based intervention for people with dementia and their carers and assessed the feasibility of a trial. AIM: Phase 2 of the programme aims to 1) refine the programme theory on how, when, and for whom the intervention works; and 2) evaluate its value and impact. DESIGN & SETTING: A realist longitudinal mixed-methods evaluation will be conducted in urban, rural, and coastal areas across South West and North West England where low-income or ethnic minority populations (for example, South Asian) are represented. Design was informed by patient, public, and professional stakeholder input and phase 1 findings. METHOD: High-volume qualitative and quantitative data will be collected longitudinally from people with dementia, carers, and practitioners. Analyses will comprise the following: 1) realist longitudinal case studies; 2) conversation analysis of recorded interactions; 3) statistical analyses of outcome and experience questionnaires; 4a) health economic analysis examining costs of delivery; and 4b) realist economic analysis of high-cost events and 'near misses'. All findings will be synthesised using a joint display table, evidence appraisal tool, triangulation, and stakeholder co-analysis. CONCLUSION: The realist evaluation will describe how, why, and for whom the intervention does or does not lead to change over time. It will also demonstrate how a non-randomised design can be more appropriate for complex interventions with similar questions or populations.
Health and Community Sciences
Faculty of Health and Life Sciences
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