Article Text

Protocol
Implementation of a diagnostic decision aid for people with memory complaints and their general practitioners: a protocol of a before and after pilot trial
  1. Iris Linden1,
  2. Claire Wolfs1,
  3. Marieke Perry2,
  4. Job Metsemakers3,
  5. Trudy van der Weijden3,
  6. Marjolein de Vugt1,
  7. Frans R Verhey1,
  8. Ron Handels1,
  9. Marcel Olde Rikkert2,4,
  10. Carmen Dirksen3,5,
  11. Rudolf W H M Ponds1,6
  1. 1Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
  2. 2Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboudumc, Nijmegen, The Netherlands
  3. 3Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands
  4. 4Department of Geriatric Medicine, Donders Institute for Brain Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
  5. 5Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre+, Maastricht, The Netherlands
  6. 6Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr Claire Wolfs; claire.wolfs{at}maastrichtuniversity.nl

Abstract

Introduction Researchers, policy-makers and healthcare professionals often stress the importance of an early dementia diagnosis. Empirical evidence, however, is scarce leading to a lack of consensus on the necessity of diagnosing dementia early. We emphasise the need for a ‘timely’ diagnosis, that is, one that occurs at the right moment for a person with memory complaints and his/her significant other. As the optimal timing differs between individuals, the implementation of shared decision making (SDM), preferably by the general practitioner (GP), as the start of a diagnostic trajectory, could help to determine this timely moment. SDM, however, is rarely practised with respect to dementia diagnoses. Therefore, in the context of the Shared Decision-Making regarding Dementia Diagnosis project, a patient decision aid (PtDA) for ‘timely’ dementia diagnosis in general practice will be developed. This protocol will describe the planned before and after evaluation of its implementation.

Methods and analysis In a mixed-methods pilot study, we will investigate decision-making processes and experiences regarding a diagnostic trajectory before and after the introduction of a PtDA for people with memory complaints, their significant others and their GPs. The ‘before group’ will receive diagnostics as usual from their GPs. The ‘after group’ will use the PtDA. We expect the PtDA to increase the level of SDM and to contribute to a timely and personalised diagnostic trajectory. Data will be collected using semistructured interviews, questionnaires and information retrieved from people with memory complaints’ medical records.

Ethics and dissemination This study protocol was approved by the Medical Review Ethics Committee of the Maastricht University Medical Centre. The findings will be published in peer-reviewed international journals and presented at conferences. This study was funded by the public funded Dutch Research Institute for Care and Medical Sciences (ZonMw).

Trial registration number NCT04531956.

  • dementia
  • old age psychiatry
  • qualitative research
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

Footnotes

  • Contributors CW, RWHMP, CD and MP initiated the S-DeciDeD project and provided ZonMw (funder of the S-DeciDeD project) with a detailed and elaborate study protocol. IL was responsible for the recruitment of general practitioners and for obtaining ethical approval from the MEC of Maastricht. IL rewrote the study protocol for publication in BMJ Open under the supervision of CW, MP, RWHMP and CD. JM, TvdW, MdV, FRV, RH and MOR are part of the projectteam and read and approved the manuscript.

  • Funding This work was supported by ZonMw grant number 70-73305-98-1225. ZonMw has approved the project proposal in which the method and the design of the study were determined. This study protocol is in accordance with the project proposal.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.