Background:
Dementia is increasing in prevalence as the population ages. An earlier rather than later diagnosis allows persons with dementia and their families to plan ahead and access appropriate management. However, most diagnoses are made by general practitioners (GPs) later in the course of the disease and are associated with management that is poorly adherent to recommended guidelines. This trial examines the effectiveness of a peer led educational intervention for GPs.
Methods:
The study is a cluster randomised trial, conducted across three states and five sites. All GPs will complete a dementia audit of their patients aged 75 years or more at three time points – baseline, 12 and 24 months. GPs allocated to the intervention group will receive two educational sessions from a peer GP or nurse, and will administer the GPCOG to consenting patients at baseline and 12 months. The first education session will provide information about dementia and the second will provide individualised feedback on audit results. GPs in the waitlist group will receive the RACGP Guidelines by post following the 12 month audit.Outcomes: Primary outcomes are carer and consumer quality of life and depression. Secondary outcomes include: rates of GP identification of dementia compared to a gold standard CAMCOG assessment; GP identification of differential diagnoses including reversible causes of cognitive impairment; and GP referral to specialists, Alzheimers’ Australia and support services. A "case finding" and a "screening" group will be compared and the psychometrics of the GPCOG will be examined.Sample size: Approximately 2,000 subjects aged 75 years and over will be recruited through approximately 160 GPs, to yield approximately 200 subjects with dementia (reducing to 168 by 24 months).DiscussionThe trial outlined in this paper has been peer reviewed and supported by the Australian National Health and Medical Research Council. At the time of submission of this paper over 2,000 subjects have been recruited and the intervention delivered to over 160 GPs.