Abstract

BackgroundCore outcome sets (COS) prioritise outcomes based on their importance to key stakeholders, reduce reporting bias and increase comparability across studies. The first phase of a COS study is to form a ‘long-list’ of outcomes. Key stakeholders then decide on their importance. COS reporting is described as suboptimal and this first phase is often under-reported. Our objective was to develop a ‘long-list’ of outcome items for non-pharmacological interventions for people with dementia living at home.MethodsThree iterative phases were conducted. First, people living with dementia, care partners, health and social care professionals, policymakers and researchers (n = 55) took part in interviews or focus groups and were asked which outcomes were important. Second, existing dementia trials were identified from the ALOIS database. 248 of 1009 pharmacological studies met the inclusion criteria. Primary and secondary outcomes were extracted from a 50% random sample (n = 124) along with eight key reviews/qualitative papers and 38 policy documents. Third, extracted outcome items were translated onto an existing qualitative framework and mapped into domains. The research team removed areas of duplication and refined the ‘long-list’ in eight workshops.ResultsOne hundred seventy outcome items were extracted from the qualitative data and literature. The 170 outcome items were consolidated to 54 in four domains (Self-Managing Dementia Symptoms, Quality of Life, Friendly Neighbourhood & Home, Independence).ConclusionsThis paper presents a transparent blueprint for ‘long-list’ development. Though a useful resource in their own right, the 54 outcome items will be distilled further in a modified Delphi survey and consensus meeting to identify core outcomes.

Highlights

  • Core outcome sets (COS) prioritise outcomes based on their importance to key stakeholders, reduce reporting bias and increase comparability across studies

  • The methods presented in this paper provide a comprehensive account of the identification of 54 outcome items of importance to key stakeholders, including people living with dementia, and that are used in existing trials of non-pharmacological interventions or found in other key literature

  • Outcomes in existing trials were mapped onto the qualitative framework that was initially drawn from Bamford and Bruce’s [18] work that promoted perspectives of people living with dementia and was expanded with outcome items extracted from qualitative data collection

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Summary

Introduction

Core outcome sets (COS) prioritise outcomes based on their importance to key stakeholders, reduce reporting bias and increase comparability across studies. Our objective was to develop a ‘long-list’ of outcome items for non-pharmacological interventions for people with dementia living at home. Support interventions at home, including environmental adaptations and assistive technologies, have been designed to enable people living with dementia to maintain their independence and live well with their diagnosis [3, 4]; evidence on the effectiveness of those interventions requires development [5, 6]. There is a growing demand to evaluate and improve the effectiveness of non-pharmacological communitybased interventions and optimise outcomes for people living with dementia at home in their neighbourhoods and communities [7,8,9]. These outcomes can be specific or diverse focusing on, for example, quality of care, service supports, improvement in physical, mental or emotional wellbeing and so on [14]

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