AbstractBackgroundDementia with Lewy bodies (DLB) is a challenging condition to treat. People with DLB present with a range of cognitive, neuropsychiatric, sleep, motor, and autonomic symptoms. These symptoms can vary in severity between patients and fluctuate over time within an individual. Treating one symptom can led to the worsening of another and often symptoms are treated in isolation by different specialists leading to sub‐optimal care. The evidence base, particularly for pharmacological interventions is building and this is bolstered by an increasing evidence base in related conditions such as Parkinson's disease which have relevance for DLB. A way forward would be to provide a holistic symptom‐based management toolkit, inclusive of the existing evidence base and drawing upon consensus expert opinion.MethodTaking a tri‐partite approach we 1) reviewed the existing evidence base in DLB 2) ran public‐patient workshops to identify best practice in DLB management based on lived experience 3) conducted a Delphi consensus process with a panel of experts in the field of Lewy body disease to determine best management practise. These activities led to the production of a holistic management toolkit which consisted of clinical summary sheets and detailed management guidelines. This toolkit was then trialled in a cluster randomized control study across 23 clinical services (e.g. memory clinics, movement disorders services etc.) in two UK regions, assessing the outcomes for patients and carers as secondary measures.ResultThe toolkit produced included 161 management statements covering a range of symptoms (cognitive, motor, neuropsychiatric, sleep and autonomic). In the trial 131 participants were recruited with 6 month data in 108 and provided preliminary evidence to suggest less marked patient deterioration on the global outcome measure (p<0.05) as well as improvements in care‐giver burden (p<0.01) and depression (p<0.05) in services using the toolkit compared to treatment as usual.ConclusionDeveloping a holistic management toolkit based on evidence base and expert opinion may have benefits for people living with DLB and their care‐givers.