Effectiveness of educational interventions in improving detection and management of dementia in primary care: cluster randomised controlled study.
OBJECTIVE
To test the effectiveness of educational interventions in improving detection rates and management of dementia in primary care.


METHODS
Unblinded, cluster randomised, before and after controlled study.


METHODS
General practices in the United Kingdom (central Scotland and London) between 1999 and 2002.


METHODS
Three educational interventions: an electronic tutorial carried on a CD Rom; decision support software built into the electronic medical record; and practice based workshops.


METHODS
36 practices participated in the study. Eight practices were randomly assigned to the electronic tutorial; eight to decision support software; 10 to practice based workshops; and 10 to control. Electronic and manual searches yielded 450 valid and usable medical records.


METHODS
Rates of detection of dementia and the extent to which medical records showed evidence of improved concordance with guidelines regarding diagnosis and management.


RESULTS
Decision support software (P = 0.01) and practice based workshops (P = 0.01) both significantly improved rates of detection compared with control. There were no significant differences by intervention in the measures of concordance with guidelines.


CONCLUSIONS
Decision support systems and practice based workshops are effective educational approaches in improving detection rates in dementia.
Bradford Dementia Group, Division of Dementia Studies, School of Health Studies, University of Bradford, Bradford BD5 0BB. m.downs@bradford.ac.uk
Murna
M
Downs
Stephen
S
Turner
Michelle
M
Bryans
Jane
J
Wilcock
John
J
Keady
Enid
E
Levin
Ronan
R
O'Carroll
Kate
K
Howie
Steve
S
Iliffe
D000368:Aged; D016251:CD-ROM; D002983:Clinical Competence / Q000592:standards; D016000:Cluster Analysis; D003194:Computer-Assisted Instruction / Q000379:methods / Q000592:standards; D003661:Decision Support Techniques; D003704:Dementia / Q000175:diagnosis* / Q000628:therapy; D004503:Education, Medical, Graduate / Q000379:methods*; D005194:Family Practice / Q000193:education* / Q000592:standards; D006801:Humans; D008131:London; D012606:Scotland