Using Academic Detailing to enhance the knowledge, skills and attitudes of clinicians caring for patients with behavioral and psychological symptoms of dementia: 18‐month follow‐up

Abstract

AbstractBackgroundApproximately 90% of persons with dementia experience behavioral and psychological symptoms of dementia (BPSD) over the course of their illness. Primary care clinicians often provide care because specialty geriatric psychiatry consultation may be difficult to obtain. Academic detailing (AD) is an evidence‐based approach for engaging and persuading healthcare professionals to make changes in their practice. We sought to enhance the knowledge, skills and attitudes of primary care providers’ care of patients with BPSD using the AD model.MethodsWe implemented AD in an urban clinic serving a largely Black community and a rural clinic serving a largely White community. Each AD visit included didactic content, case discussion, and consultation regarding patients. Eleven visits over 18 months were planned for each site. Outcome measures included a 10‐item multiple‐choice knowledge assessment and an adaptation of the General Practitioners Attitude and Confidence Scale for Dementia at baseline, 6 and 18 months, and Likert‐scale measurement of acceptability at 6 and 18 months, all self‐report. Differences in knowledge and attitude scores were determined for those providing complete responses at baseline and follow‐up. Thematic analysis of qualitative feedback collected 18 months will be completed.ResultsFive urban and 14 rural providers completed baseline assessments. Providers were mostly White (95%) and Non‐Hispanic (100%); 47% were female (Table 1). Seventeen (89%) participated in one or more AD visits and 13 (68%) participated in the 6‐month survey. Knowledge, attitudes and confidence regarding BPSD and dementia care increased (Table 2). Assessments at 18‐months and qualitative analysis of case discussions are forthcoming and will be presented.ConclusionsAcademic detailing (AD) is a feasible way of increasing self‐reported knowledge and skills and improving self‐reported attitudes of primary care providers responsible for the care of patients with BPSD. Knowledge and confidence in BPSD and dementia care increased after 6 months’ participation in AD. During the pandemic we successfully adapted the AD model to a virtual platform, which has implications for portability of this model to other settings. The pilot data collected in this study will inform the design of a larger study to measure the impact of AD on patient outcomes.