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Designing a complex intervention for dementia case management in primary care

Lookup NU author(s): Professor Dame Louise Robinson



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Community-based support will become increasingly important for people with dementia, but currently services are fragmented and the quality of care is variable. Case management is a popular approach to care co-ordination, but evidence to date on its effectiveness in dementia has been equivocal. Case management interventions need to be designed to overcome obstacles to care co-ordination and maximise benefit. A successful case management methodology was adapted from the United States (US) version for use in English primary care, with a view to a definitive trial. Medical Research Council guidance on the development of complex interventions was implemented in the adaptation process, to capture the skill sets, person characteristics and learning needs of primary care based case managers. Methods: Co-design of the case manager role in a single NHS provider organisation, with external peer review by professionals and carers, in an iterative technology development process. Results: The generic skills and personal attributes were described for practice nurses taking up the case manager role in their workplaces, and for social workers seconded to general practice teams, together with a method of assessing their learning needs. A manual of information material for people with dementia and their family carers was also created using the US intervention as its source. Conclusions: Co-design produces rich products that have face validity and map onto the complexities of dementia and of health and care services. The feasibility of the case manager role, as described and defined by this process, needs evaluation in 'real life' settings.

Publication metadata

Author(s): Waugh A, Austin A, Manthorpe J, Fox C, Stephens B, Robinson L, Iliffe S

Publication type: Article

Publication status: Published

Journal: BMC Family Practice

Year: 2013

Volume: 14

Online publication date: 17/07/2013

Acceptance date: 12/07/2013

Date deposited: 26/11/2015

ISSN (electronic): 1471-2296

Publisher: Biomed Central Ltd.


DOI: 10.1186/1471-2296-14-101

PubMed id: 23865537


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Funder referenceFunder name
HTA 08/58/14HTA