title: Designing a complex intervention for dementia case management in primary care.
abstract: BACKGROUND
  Community-based support will become increasingly important for people with dementia, but currently services are fragmented and the quality of care is variable. Case management is a popular approach to care co-ordination, but evidence to date on its effectiveness in dementia has been equivocal. Case management interventions need to be designed to overcome obstacles to care co-ordination and maximise benefit. A successful case management methodology was adapted from the United States (US) version for use in English primary care, with a view to a definitive trial. Medical Research Council guidance on the development of complex interventions was implemented in the adaptation process, to capture the skill sets, person characteristics and learning needs of primary care based case managers.
  
  
  METHODS
  Co-design of the case manager role in a single NHS provider organisation, with external peer review by professionals and carers, in an iterative technology development process.
  
  
  RESULTS
  The generic skills and personal attributes were described for practice nurses taking up the case manager role in their workplaces, and for social workers seconded to general practice teams, together with a method of assessing their learning needs. A manual of information material for people with dementia and their family carers was also created using the US intervention as its source.
  
  
  CONCLUSIONS
  Co-design produces rich products that have face validity and map onto the complexities of dementia and of health and care services. The feasibility of the case manager role, as described and defined by this process, needs evaluation in 'real life' settings.
authors.affiliation: Mental Health Sciences Unit, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK. caredemstudy@gmail.com
authors.forename: Amy
authors.initials: A
authors.lastname: Waugh
authors.forename: Allana
authors.initials: A
authors.lastname: Austin
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.forename: Chris
authors.initials: C
authors.lastname: Fox
authors.forename: Barbara
authors.initials: B
authors.lastname: Stephens
authors.forename: Louise
authors.initials: L
authors.lastname: Robinson
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
mesh_terms: D001288:Attention; D019985:Benchmarking; D019090:Case Management / Q000458:organization & administration*; D003376:Counseling; D003704:Dementia / Q000628:therapy*; D004059:Diffusion of Innovation; D006293:Health Promotion; D006801:Humans; D008370:Manuals as Topic; D009313:National Health Programs; D011314:Preventive Health Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000379:methods*; D017010:Reminder Systems; D013598:Systems Theory; D006113:United Kingdom