Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol

Hannah Wheat¹, Lauren Weston², Tomasina M Oh², Sarah Morgan-Trimmer³, Wendy Ingram⁴, Sarah Griffiths⁵, Rod Sheaff⁶, Paul Clarkson⁷, Antonieta Medina-Lara⁸, Crispin Musicha⁹, Stuart Spicer², Obioha Ukoumunne¹⁰, Victoria Allgar⁴, Siobhan Creanor¹¹, Michael Clark¹², Cath Quinn², Alex Gude², Rose McCabe¹³, Saqba Batool⁷, Lorna Smith², Debra Richards², Hannah Shafi⁷, Bethany Warwick⁷, Reena Lasrado⁷, Basharat Hussain², Hannah Jones², Sonia Dalkin¹⁴, Angela Bate¹⁴, Ian Sherriff², Louise Robinson¹⁵, Richard Byng²

Affiliations

¹ Community and Primary Care Research Group, University of Plymouth, Plymouth, UK hannah.wheat-1@plymouth.ac.uk.
² Community and Primary Care Research Group, University of Plymouth, Plymouth, UK.
³ Department of Health and Community Sciences, University of Exeter, Exeter, UK.
⁴ Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK.
⁵ Centre for Ageing Population Studies, University College London, London, UK.
⁶ Peninsula Medical School, Plymouth, UK.
⁷ Social Care and Society, University of Manchester, Manchester, UK.
⁸ Health Economics Group, University of Exeter, Exeter, UK.
⁹ Medical Statistics, University of Plymouth, Plymouth, UK.
¹⁰ NIHR ARC South West Peninsula, Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
¹¹ Exeter Clinical Trials Unit, University of Exeter, Exeter, UK.
¹² Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
¹³ School of Health and Psychological Sciences, University of London, London, UK.
¹⁴ Faculty of Health and Life Science, Northumbria University, London, UK.
¹⁵ Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.

PMID: 37160337
PMCID: PMC10646200
DOI: 10.3399/BJGPO.2023.0019

Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol

Hannah Wheat et al. BJGP Open. 2023.

. 2023 Sep 19;7(3):BJGPO.2023.0019.

doi: 10.3399/BJGPO.2023.0019. Print 2023 Sep.

Authors

Affiliations

¹ Community and Primary Care Research Group, University of Plymouth, Plymouth, UK hannah.wheat-1@plymouth.ac.uk.
² Community and Primary Care Research Group, University of Plymouth, Plymouth, UK.
³ Department of Health and Community Sciences, University of Exeter, Exeter, UK.
⁴ Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK.
⁵ Centre for Ageing Population Studies, University College London, London, UK.
⁶ Peninsula Medical School, Plymouth, UK.
⁷ Social Care and Society, University of Manchester, Manchester, UK.
⁸ Health Economics Group, University of Exeter, Exeter, UK.
⁹ Medical Statistics, University of Plymouth, Plymouth, UK.
¹⁰ NIHR ARC South West Peninsula, Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
¹¹ Exeter Clinical Trials Unit, University of Exeter, Exeter, UK.
¹² Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
¹³ School of Health and Psychological Sciences, University of London, London, UK.
¹⁴ Faculty of Health and Life Science, Northumbria University, London, UK.
¹⁵ Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.

PMID: 37160337
PMCID: PMC10646200
DOI: 10.3399/BJGPO.2023.0019

Abstract

Background: Different dementia support roles exist but evidence is lacking on which aspects are best, for whom, and in what circumstances, and on their associated costs and benefits. Phase 1 of the Dementia PersonAlised Care Team programme (D-PACT) developed a post-diagnostic primary care-based intervention for people with dementia and their carers and assessed the feasibility of a trial.

Aim: Phase 2 of the programme aims to 1) refine the programme theory on how, when, and for whom the intervention works; and 2) evaluate its value and impact.

Design & setting: A realist longitudinal mixed-methods evaluation will be conducted in urban, rural, and coastal areas across South West and North West England where low-income or ethnic minority populations (for example, South Asian) are represented. Design was informed by patient, public, and professional stakeholder input and phase 1 findings.

Method: High-volume qualitative and quantitative data will be collected longitudinally from people with dementia, carers, and practitioners. Analyses will comprise the following: 1) realist longitudinal case studies; 2) conversation analysis of recorded interactions; 3) statistical analyses of outcome and experience questionnaires; 4a) health economic analysis examining costs of delivery; and 4b) realist economic analysis of high-cost events and 'near misses'. All findings will be synthesised using a joint display table, evidence appraisal tool, triangulation, and stakeholder co-analysis.

Conclusion: The realist evaluation will describe how, why, and for whom the intervention does or does not lead to change over time. It will also demonstrate how a non-randomised design can be more appropriate for complex interventions with similar questions or populations.

Keywords: caregivers; dementia; personalised care; primary health care; realist evaluation.

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Conflict of interest statement

The authors declare that no competing interests exist.

Figures

**Figure 1.. A visualisation of the D-PACT programme theory. D-PACT = Dementia PersonAlised Care Team. DSW = dementia support worker**

See this image and copyright information in PMC

References

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Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol

Affiliations

Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Miscellaneous