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Tailored educational intervention for primary care to improve the management of dementia: the EVIDEM-ED cluster randomized controlled trial


Wilcock, Jane, Iliffe, Steve, Griffin, Mark, Jain, Priya, Thuné-Boyle, Ingela, Lefford, Frances, Rapp, David


Trials, Volume: 14, Pages.: 397-397

Year of Publication



Background: Early diagnosis of dementia is important because this allows those with dementia and their families to engage support and plan ahead. However, dementia remains underdetected and suboptimally managed in general practice. Our objective was to test the effect of a workplace-based tailored educational intervention developed for general practice on the clinical management of people with dementia.; Methods: The tailored educational intervention was tested in an unblinded cluster randomized controlled trial with a pre/post-intervention design, with two arms: usual/normal care control versus educational intervention. The primary outcome measure was an increase in the proportion of patients with dementia who received at least two documented dementia-specific management reviews per year. Case identification was a secondary outcome measure.; Results: 23 practices in South-East England participated. A total of 1,072 patients with dementia (intervention: 512, control: 560) had information in their medical records showing the number of reviews within 12 months (or a proportion of) before intervention or randomization and within 12 months (or a proportion of) after. The mean total number of dementia management reviews after the educational intervention for people with dementia was 0.89 (SD 1.09; minimum 0; median 1; maximum 8) compared with 0.89 (SD 0.92; minimum 0; median 1; maximum 4) before intervention. In the control group prior to randomization the mean total number of dementia management reviews was 1.66 (SD 1.87; minimum 0; median 1; maximum 12) and in the period after randomization it was 1.56 (SD 1.79; minimum 0; median 1; maximum 11). Case detection rates were unaffected. The estimated incidence rate ratio for intervention versus control group was 1.03 (P = 0.927, 95% CI 0.57 to 1.86).; Conclusions: The trial was timely, coinciding with financial incentives for dementia management in general practice (through the Quality Outcomes Framework); legal imperatives (in the form of the Mental Capacity Act 2005); policy pressure (The National Dementia Strategy 2009); and new resources (such as dementia advisors) that increased the salience of dementia for general practitioners. Despite this the intervention did not alter the documentation of clinical management of patients with dementia in volunteer practices, nor did it increase case identification.; Trial Registration: NCT00866099/Clinical Trials.;

Bibtex Citation

@article{Wilcock_2013, doi = {10.1186/1745-6215-14-397}, url = {}, year = 2013, publisher = {Springer Nature}, volume = {14}, number = {1}, pages = {397}, author = {Jane Wilcock and Steve Iliffe and Mark Griffin and Priya Jain and Ingela Thun{'{e}}-Boyle and Frances Lefford and David Rapp}, title = {Tailored educational intervention for primary care to improve the management of dementia: the {EVIDEM}-{ED} cluster randomized controlled trial}, journal = {Trials} }


adult, aged, aged, 80 and over, care, data collection, dementia, educational, female, for, gps, humans, in, intervention, male, management, middle aged, of, outcome assessment (health care), primary, primary health care, receipt, reviews, sample size, therapy

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Other, Service use or cost reductions (incl. hospital use reduction, care home admission delay)


Primary Care

Type of Interventions

Diagnostic Target Identification, Workforce oriented interventions

Diagnostic Targets


Workforce Interventions

Professional Training / Continuing Professional Development