Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol

Introduction The multifaceted impact of dementia means that people living with dementia require multidisciplinary care across different services and settings; however, these care transitions pose a risk of fragmented care. Models that improve integration and coordination of care in the community are...

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Main Authors: John Attia, Jennifer White, Christopher Oldmeadow, Joel J Rhee, Simon Deeming, Michelle Kelly, Anna Williams, Kylie Wales, Yun-Hee Jeon, John Ward, Dimity Pond, Kate Wood, Mariko L Carey, Kristy Fakes, Balakrishnan R Nair, Kay Khaing, Mandy Harden, Claudine Ford, Stephanie Lithgow, Jaishree Jalewa, Emma Smart, Amelia Bartczak
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/4/e095473.full
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author John Attia
Jennifer White
Christopher Oldmeadow
Joel J Rhee
Simon Deeming
Michelle Kelly
Anna Williams
Kylie Wales
Yun-Hee Jeon
John Ward
Dimity Pond
Kate Wood
Mariko L Carey
Kristy Fakes
Balakrishnan R Nair
Kay Khaing
Mandy Harden
Claudine Ford
Stephanie Lithgow
Jaishree Jalewa
Emma Smart
Amelia Bartczak
author_facet John Attia
Jennifer White
Christopher Oldmeadow
Joel J Rhee
Simon Deeming
Michelle Kelly
Anna Williams
Kylie Wales
Yun-Hee Jeon
John Ward
Dimity Pond
Kate Wood
Mariko L Carey
Kristy Fakes
Balakrishnan R Nair
Kay Khaing
Mandy Harden
Claudine Ford
Stephanie Lithgow
Jaishree Jalewa
Emma Smart
Amelia Bartczak
author_sort John Attia
collection DOAJ
description Introduction The multifaceted impact of dementia means that people living with dementia require multidisciplinary care across different services and settings; however, these care transitions pose a risk of fragmented care. Models that improve integration and coordination of care in the community are needed.Methods and analysis This randomised control trial will test the effectiveness and cost effectiveness of a dementia nurse-led intervention to: (1) increase days lived in the community at 12-month follow-up (primary outcome) among people living with dementia and (2) improve quality of life for people living with dementia and their carers, compared with usual care. Participants are recruited from several sources including private and public geriatric medicine clinics, carer support groups and self-referral. People living with dementia and their carers are randomised as a dyad to (1) usual care or (2) dementia nurse-led care-coordination. The dementia nurse will provide care coordination and direct support through a tailored, integrated and patient-centred approach. The needs of people living with dementia will be identified and addressed, with a focus on improving the management of comorbidities, risk reduction and symptoms. Carers will also receive support. The model for people living with dementia will focus on days lived in their community as the outcome variable. Differences between groups in quality of life at 12-month follow-up will be assessed using linear mixed effects regression. Analysis will follow the intention to treat principles. People living with dementia and carers’ data will be analysed separately and collectively for the economic study.Ethics and dissemination The trial has been approved by the Hunter New England Research Ethics Committee (2023/ETH01221) and the University of Newcastle Ethics Committee (R-2024–0021). Trial findings will be disseminated via peer-reviewed publications and conference presentations. If the intervention is effective, the research team aims to further implement the intervention as usual care within the participating services and beyond.Trial registration number The trial was prospectively registered via the Australian New Zealand Clinical Trials Registry: ACTRN12624000235505. Registration date: 11 March 2024.
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spelling doaj-art-13ea8410cd6a46688cefb44d49cfc0762025-08-20T02:26:41ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-095473Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocolJohn Attia0Jennifer White1Christopher Oldmeadow2Joel J Rhee3Simon Deeming4Michelle Kelly5Anna Williams6Kylie Wales7Yun-Hee Jeon8John Ward9Dimity Pond10Kate Wood11Mariko L Carey12Kristy Fakes13Balakrishnan R Nair14Kay Khaing15Mandy Harden16Claudine Ford17Stephanie Lithgow18Jaishree Jalewa19Emma Smart20Amelia Bartczak21School of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaHunter Medical Research Institute, New Lambton Heights, New South Wales, AustraliaDiscipline of General Practice, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaSchool of Psychological Science, College of Engineering, Science and Environment, The University of Newcastle Australia, Callaghan, New South Wales, AustraliaFaculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Broadway, New South Wales, AustraliaSchool of Health Sciences, The University of Newcastle, Callaghan, New South Wales, AustraliaSusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, AustraliaHunter Ageing Alliance, Newcastle, New South Wales, AustraliaWicking Dementia Research and Teaching Centre, University of Tasmania, Hobart, Tasmania, AustraliaNDIS and Chronic Disease, Hunter Primary Care Ltd, Warabrook, New South Wales, AustraliaHunter Medical Research Institute, New Lambton Heights, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaHunter New England Local Health District, New Lambton, New South Wales, AustraliaNDIS and Chronic Disease, Hunter Primary Care Ltd, Warabrook, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaNDIS and Chronic Disease, Hunter Primary Care Ltd, Warabrook, New South Wales, AustraliaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, AustraliaIntroduction The multifaceted impact of dementia means that people living with dementia require multidisciplinary care across different services and settings; however, these care transitions pose a risk of fragmented care. Models that improve integration and coordination of care in the community are needed.Methods and analysis This randomised control trial will test the effectiveness and cost effectiveness of a dementia nurse-led intervention to: (1) increase days lived in the community at 12-month follow-up (primary outcome) among people living with dementia and (2) improve quality of life for people living with dementia and their carers, compared with usual care. Participants are recruited from several sources including private and public geriatric medicine clinics, carer support groups and self-referral. People living with dementia and their carers are randomised as a dyad to (1) usual care or (2) dementia nurse-led care-coordination. The dementia nurse will provide care coordination and direct support through a tailored, integrated and patient-centred approach. The needs of people living with dementia will be identified and addressed, with a focus on improving the management of comorbidities, risk reduction and symptoms. Carers will also receive support. The model for people living with dementia will focus on days lived in their community as the outcome variable. Differences between groups in quality of life at 12-month follow-up will be assessed using linear mixed effects regression. Analysis will follow the intention to treat principles. People living with dementia and carers’ data will be analysed separately and collectively for the economic study.Ethics and dissemination The trial has been approved by the Hunter New England Research Ethics Committee (2023/ETH01221) and the University of Newcastle Ethics Committee (R-2024–0021). Trial findings will be disseminated via peer-reviewed publications and conference presentations. If the intervention is effective, the research team aims to further implement the intervention as usual care within the participating services and beyond.Trial registration number The trial was prospectively registered via the Australian New Zealand Clinical Trials Registry: ACTRN12624000235505. Registration date: 11 March 2024.https://bmjopen.bmj.com/content/15/4/e095473.full
spellingShingle John Attia
Jennifer White
Christopher Oldmeadow
Joel J Rhee
Simon Deeming
Michelle Kelly
Anna Williams
Kylie Wales
Yun-Hee Jeon
John Ward
Dimity Pond
Kate Wood
Mariko L Carey
Kristy Fakes
Balakrishnan R Nair
Kay Khaing
Mandy Harden
Claudine Ford
Stephanie Lithgow
Jaishree Jalewa
Emma Smart
Amelia Bartczak
Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol
BMJ Open
title Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol
title_full Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol
title_fullStr Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol
title_full_unstemmed Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol
title_short Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol
title_sort randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers study protocol
url https://bmjopen.bmj.com/content/15/4/e095473.full
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