Promoting Brain Health in clinical communication: Exploring if, when and how clinicians communicate the risk of dementia (CoRD).
Overview of the project
Globally, dementia is the most frequent form of degenerative condition in older adults and poses a major health and economic crisis (costing over $1 trillion) (Prince et al, 2015). Attempts to find a cure have been unsuccessful, prompting a focus on interventions aimed at promoting Brain Health. There is growing evidence that modifying health behaviours may prevent or delay dementia by 40% (ARUK, 2021). Prevention strategies include, improved diet, smoking cessation, reduced alcohol consumption, exercise, and management of pre-existing heart disease or diabetes (Livingston et al, 2020). There are two key points where dementia prevention can be communicated (1) in primary care by General Practitioners (GP’s), and (2) in secondary care with adults diagnosed with Mild Cognitive Impairment (MCI) or Functional Cognitive Disorder (FCD), but not yet dementia. There is currently little evidence about if, when and how Brain Health, dementia risk and risk modifying behaviours are communicated to patients by healthcare professionals.
Aims of the study
This exploratory research aims to better understand if, when and how Brain Health is promoted in clinical communication, in particular exploring if and how dementia risk and prevention are discussed with patients. Our specific objectives are to:
- Explore the role of primary care practitioners in the primary prevention of dementia. We seek to enquire if, when and how General practitioner’s (GP’s) promote Brain Health, discuss dementia risk and risk reduction with patients in primary practice.
- Explore if and how specialist clinicians communicate dementia risk and risk reduction in memory clinic encounters when patients are diagnosed with Mild Cognitive Impairment or Functional Cognitive Disorder.
- Discover if there is a clinical consensus on the importance of discussing Brain Health, dementia risk and risk reduction, and when and how best to do so?
This study consists of two work packages (WP)
WP1: (Q1 and 3) Focus groups/interviews will be conducted with GP’s. Data will be transcribed and analysed using thematic analysis.
WP2: This will involve secondary analysis of video recordings of diagnosis feedback meetings across nine UK-based secondary care memory clinics, from the NIHR ShareD study: “Shared decision making in mild to moderate dementia” (see - https://fundingawards.nihr.ac.uk/award/PB-PG-1111-26063). The data consists of a sample of 63 recordings (n= 47 MCI, n=16 FCD) which will be screened for communication about dementia risk, risk modifying behaviours and promotion of Brain Health. Data will be transcribed, and Conversation analysis (CA) will be used to analyse the data to enable description of the communication practices clinicians use (Q2). CA is proven to be a suitable method for exploring clinical communication in memory services (Dooley, et al 2019).
Principle Investigator: Dr Danielle Jones, Associate Professor in Dementia Studies, Centre for Applied Dementia Studies, University of Bradford - https://www.bradford.ac.uk/staff/dkjones1
Professor Siobhan Reilly, Centre for Applied Dementia Studies, University of Bradford
Professor Rose McCabe – City University, London
Dr Jemima Dooley – Exeter University
SURE funding – University of Bradford