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Feasibility and Acceptability of a Clinician-Caregiver Co-Designed Dementia Care Intervention for Home-Based Primary
Christine Ritchie1, Bruce Leff2, Maimouna Sy1
1Center for Aging and Serious Illness, Department of Geriatrics and Palliative Medicine Massachusetts General Hospital, Boston, Massachusetts, USA.
Background:
Of 7.5 million American older adults who are completely homebound or cannot leave home without significant difficulty, half live with dementia. Home-based primary care (HBPC) practices provide longitudinal medical care in patients' homes but may not be equipped to provide high-quality dementia care.
Methods:
Two HBPC practices and 50 caregivers of patients living with dementia (PLWD) participated in the Dementia Care Quality at Home (DCQH) intervention, which was adapted through the FRAME framework for the HBPC setting from the Care Ecosystem dementia care model and CRESCENT. DCQH leveraged the study team's clinical experience and input from focus groups of HBPC practices and caregivers of PLWD receiving HBPC to adapt the intervention to the home setting. DCQH consisted of a standardized baseline needs assessment, six dementia care modules prioritized based on assessment findings, and 60-min biweekly team-based case reviews. Outcomes measures included practice acceptability/feasibility (based on qualitative interviews, completion of needs assessment, and use of intervention materials) and caregiver acceptability (based on caregiver agreement to participate and satisfaction with DCQH).
Results:
Study enrollment included 21 practice members and 50 caregivers; 63% of caregivers approached enrolled in the intervention. All caregivers completed baseline assessments and were given educational materials and community resources; 90% were satisfied with the intervention; 93% reported feeling "heard or understood," and the net promoter score on likelihood to recommend the intervention was 8.8/10.
Conclusions:
This study demonstrates the feasibility and acceptability of an adapted dementia care intervention to meet the unique needs of HBPC patients with dementia, their caregivers, and the HBPC practices that serve them. Additional study of the efficacy and effectiveness of DCQH in HBPC is warranted.
Trial Registration:
ClinicalTrials.gov identifier: NCT05849259.
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