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Open Access Highly Accessed Study protocol

Ageing in general practice (AGP) trial: a cluster randomised trial to examine the effectiveness of peer education on GP diagnostic assessment and management of dementia

Constance D Pond1, Henry Brodaty2, Nigel P Stocks3, Jane Gunn4, John Marley1, Peter Disler5, Parker Magin1, Nerida Paterson1, Graeme Horton1, Susan Goode1, Bronwen Paine3 and Karen E Mate16*

Author Affiliations

1 School of Medicine and Population Health, University of Newcastle, Newcastle, Australia 2308

2 School of Psychiatry, University of New South Wales, Sydney, Australia 2052

3 School of Population Health and Clinical Practice, The University of Adelaide, Adelaide, Australia 5005

4 Department of General Practice, University of Melbourne, Melbourne, Australia 3010

5 School of Rural Health, Monash University, Melbourne, Australia 3800

6 School of Biomedical Science & Pharmacy, University of Newcastle, Newcastle, Australia 2308

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BMC Family Practice 2012, 13:12  doi:10.1186/1471-2296-13-12

Published: 7 March 2012

Abstract

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 dementia educational intervention for GPs.

Methods

The study is a cluster randomised trial, conducted across three states and five sites. All GPs will complete an audit of their consenting 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 more detailed gold standard assessment conducted in the patient's home; 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).

Discussion

The 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 2,034 subjects have been recruited and the intervention delivered to 114 GPs.

Trial registration

Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12607000117415.