Supporting primary care practitioners to promote dementia risk reduction in Australian general practice: outcomes of a cross-sectional, non-randomised implementation pilot study.

Kali Godbee, Victoria J Palmer, Jane M Gunn, Nicole T Lautenschlager, Jill J Francis
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Abstract

Background Primary care practitioners worldwide are urged to promote dementia risk reduction as part of preventive care. To facilitate this in Australian primary care, we developed the Umbrella intervention, comprising a waiting room survey and patient information cards for use in consultations. Educational and relational strategies were employed to mitigate implementation barriers. Methods In this cross-sectional, non-randomised implementation study within the South East Melbourne Primary Health Network, we employed mixed-methods outcome evaluation. Antecedent outcomes (acceptability, appropriateness, and feasibility) and actual outcomes (adoption, penetration, and fidelity) were assessed from the perspective of primary care practitioners and patients. Results Five practices piloted the intervention and implementation strategies, including 16 primary care practitioners engaging with 159 patients. The Umbrella intervention was deemed acceptable, appropriate, and feasible, but penetration was limited. Approximately half of eligible primary care practitioners used the intervention, with moderate fidelity. Engagement with implementation strategies was similarly limited. While most strategies were well-received, improvements in online peer discussions and staff readiness were desired. Conclusions The Umbrella intervention is a viable approach to promoting dementia risk reduction in Australian general practice, supported by educational and relational strategies. Stakeholder-informed refinements to enhance uptake are recommended before advancing to a definitive trial.

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支持初级保健从业人员在澳大利亚全科实践中促进降低痴呆症风险:一项横断面、非随机实施试点研究的成果。
背景世界各地的初级保健医生都被敦促将降低痴呆风险作为预防保健的一部分。为了在澳大利亚的初级保健中推广这项工作,我们制定了 "保护伞 "干预措施,其中包括候诊室调查和用于咨询的患者信息卡。我们采用了教育和关系策略来减少实施障碍。方法 在墨尔本东南初级医疗网络内进行的这项横断面、非随机实施研究中,我们采用了混合方法进行结果评估。从初级保健从业人员和患者的角度对前因结果(可接受性、适宜性和可行性)和实际结果(采用率、渗透率和忠实度)进行了评估。结果 五家医疗机构对干预措施和实施策略进行了试点,其中包括 16 名初级保健医生和 159 名患者。人们认为 "保护伞 "干预措施是可接受的、适当的和可行的,但其普及程度有限。约有一半符合条件的初级保健医生使用了干预措施,忠实度一般。实施策略的参与度同样有限。虽然大多数策略受到好评,但希望在线同伴讨论和员工准备工作有所改进。结论 在教育和关系策略的支持下,"保护伞 "干预措施是在澳大利亚全科医生中推广降低痴呆风险的可行方法。建议在进行确定性试验之前,根据利益相关者的意见进行改进,以提高干预效果。
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