Does education of general practitioners improve dementia care?

In 2013, Jane Wilcock and her colleagues conducted a cluster randomised controlled trial in the UK to find answers to the above question.  A qualified and experienced General Practitioners conducted practice-based workshops for consenting general practitioners in 23 practices.

The workshop sessions first assessed their educational needs and then addressed those needs. Their primary hypothesis was that the proportions of individuals with dementia would differ by 50% (20% in the control group and 70% in the intervention group) after the intervention. The outcome data were assessed by an independent group of professionals with expertise. The participating centres were randomised to the intervention and control groups by an independent staff using a computer randomization program. The trial lasted 36 months including a 12-months of the follow-up period.

Multi-level Poisson regression modelling was carried out using SPSS to compare dementia diagnosis rates for 12 months prior and after the intervention. They did not find any statistically significant change in diagnosis rates after the intervention.

They cited two possible reasons for this finding:

  1. The intervention must have been not strong enough to make a change.

2. The intervention might have been underpowered to detect 50% change; although not measured, other preliminary changes prior to behaviour change – knowledge increase, attitude change, intent to act – must have been occurred. 

The researchers concluded that a tailored education intervention for general practitioners did not improve documentation of clinical management of people with dementia or dementia case detection, even when policy pressure and consumer demand were present, and reimbursement system was in place.

This means that there should be other additional support to complement to an educational intervention.

Anyone who is interested to read the full paper, it could be found clicking this link: https://www.ncbi.nlm.nih.gov/pubmed/24257429

Please note that I do not have any affiliation with the study or group.

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Author: Prasantha De Silva

A specialist in Community Medicine board-certified in Sri Lanka and a research analyst in Canada

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