Effectiveness of educational interventions in improving detection and management of dementia in primary care: cluster randomised controlled study.

Abstract

To test the effectiveness of educational interventions in improving detection rates and management of dementia in primary care. Unblinded, cluster randomised, before and after controlled study. General practices in the United Kingdom (central Scotland and London) between 1999 and 2002. Three educational interventions: an electronic tutorial carried on a CD Rom; decision support software built into the electronic medical record; and practice based workshops. 36 practices participated in the study. Eight practices were randomly assigned to the electronic tutorial; eight to decision support software; 10 to practice based workshops; and 10 to control. Electronic and manual searches yielded 450 valid and usable medical records. Rates of detection of dementia and the extent to which medical records showed evidence of improved concordance with guidelines regarding diagnosis and management. Decision support software (P = 0.01) and practice based workshops (P = 0.01) both significantly improved rates of detection compared with control. There were no significant differences by intervention in the measures of concordance with guidelines. Decision support systems and practice based workshops are effective educational approaches in improving detection rates in dementia.