Facing Dementia in Primary Care: Applying the COM-B Model to Develop a Complex Intervention to Improve Dementia Diagnosis Rates in General Practice

As the population ages and new therapies become available, general practitioners will have a significant role in the early detection, diagnosis, and management of dementia. However, both in Australia and globally dementia remains under-recognised and under-diagnosed in primary care. The aim of this study is to develop a complex intervention, informed by behaviour change theory, to improve rates of dementia diagnoses in Australian primary care. Co-design participants included GPs, general practice nurses, practice managers and reception staff. A program logic model was used to describe the essential activities and mechanisms of the intervention. Six behaviour changes: education, training, enablement, modelling, persuasion, and environmental restructuring—were identified to address the identified barriers to dementia diagnosis in primary care. The intervention is comprised of seven activities – peer-led online dementia education and training, geriatrician ‘drop-in’ online support sessions, quality improvement in dementia care sessions, stand-alone videos, auditing and benchmarking, a dementia risk alert tool and a set of dementia diagnosis and management decision-making resources. Using behaviour change theory can assist in the development of complex interventions aimed at changing clinical practice and may assist in their evaluation.