title: 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.
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
  
  
  RESULTS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12607000117415.
authors.affiliation: School of Medicine and Population Health, University of Newcastle, Newcastle, Australia 2308.
authors.forename: Constance D
authors.initials: CD
authors.lastname: Pond
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Nigel P
authors.initials: NP
authors.lastname: Stocks
authors.forename: Jane
authors.initials: J
authors.lastname: Gunn
authors.forename: John
authors.initials: J
authors.lastname: Marley
authors.forename: Peter
authors.initials: P
authors.lastname: Disler
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.forename: Nerida
authors.initials: N
authors.lastname: Paterson
authors.forename: Graeme
authors.initials: G
authors.lastname: Horton
authors.forename: Susan
authors.initials: S
authors.lastname: Goode
authors.forename: Bronwen
authors.initials: B
authors.lastname: Paine
authors.forename: Karen E
authors.initials: KE
authors.lastname: Mate
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D054869:Clinical Audit; D016000:Cluster Analysis; D003704:Dementia / Q000175:diagnosis* / Q000628:therapy*; D005194:Family Practice / Q000193:education*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D010379:Peer Group; D010821:Physicians, Family / Q000193:education*; D016896:Treatment Outcome