Delivery of cognition‐oriented treatments for older people with MCI in Australian Memory Clinics: A pilot implementation study

Abstract

AbstractBackgroundThere is good evidence that cognition‐oriented treatments (COTs) including cognitive training and rehabilitation benefit older adults, including those with mild cognitive impairment or dementia. Despite this, there remains a research‐to‐practice gap where these interventions are not readily available in clinical practice. This paper will describe the protocol for a pilot/feasibility implementation study of rolling out COTs for people with MCI in the Australian Memory Clinic Network.MethodThe Australian Dementia Network (ADNeT) Working Group on Cognitive Interventions is tasked with bridging the evidence‐practice gap in Australian Memory Clinics. We have conducted a scoping review of COT implementation efforts around the world, a multi stakeholder survey to understand needs in gaps, have developed an online clinician‐training toolkit for choosing and delivering interventions, and are conducting an implementation study in 2023 using the RE‐AIM Implementation Framework (Glasgow et al. 2019; www.re‐aim.org), assessing Reach, Efficacy, Adoption, Implementation, and Maintenance of COTs in six participating clinics throughout Australia.ResultOur scoping review identified 29 eligible studies but only four have used formal implementation frameworks. Cognitive stimulation was the most frequent approach in these studies, and only a small proportion investigated cost‐effectiveness and maintenance parameters. The stakeholder survey confirmed that clinicians believe it is very important to offer interventions as part of routine clinical practice, and that more training was required. Progress of our implementation study to date will be described including the clinician training tool.ConclusionThis is the first study in Australia to address the evidence‐practice gap in COT research, and will inform the development of a larger implementation study to continue building the evidence base for the costs and benefits associated with incorporating these evidence‐based approaches in clinical practice.