When is audit and feedback effective in dementia care? A systematic review

Area of Science:

• Gerontology
• Health Services Research
• Clinical Quality Improvement

Background:

• Ensuring evidence-based care for individuals with dementia is a critical priority for patients, caregivers, and healthcare providers.
• Despite its importance, evidence suggests that people with dementia do not consistently receive optimal care.
• Audit and feedback (clinical audit) is a widely adopted intervention aimed at enhancing healthcare quality, yet its optimal application remains unclear.

Purpose of the Study:

• To evaluate the effectiveness of audit and feedback in improving the quality of care provided by health professionals to people with dementia.
• To determine how the content and delivery methods of audit and feedback influence its efficacy in dementia care settings.

Main Methods:

• A systematic review was conducted, searching multiple databases including Medline, PsycInfo, Embase, and the Science Citation Index.
• Search terms combined concepts related to audit and feedback, health personnel, and dementia.
• Data were extracted using the Template for Intervention Description and Replication (TIDieR) and synthesized using harvest plots and narrative methods.

Main Results:

• Thirteen studies met the inclusion criteria for the review.
• Most studies employed a before-and-after design, with limited reporting on multiple audit cycles or comparison groups.
• While the median absolute improvement in dementia care appeared higher than in non-dementia studies with stronger designs, significant variation in audit and feedback effectiveness was observed.

Conclusions:

• Methodological and reporting limitations in the reviewed studies restrict definitive conclusions about the effectiveness of audit and feedback in dementia care.
• The substantial variation in outcomes highlights the need for further investigation into the factors influencing the effectiveness of this intervention.