Spector, Aimee, Stoner, Charlotte R ORCID: 0000-0002-1536-4347, Chandra, Mina, Vaitheswaran, Sridhar, Du, Bharath, Comas-Herrera, Adelina, Dotchin, Catherine, Ferri, Cleusa, Knapp, Martin, Krishna, Murali, Laks, Jerson, Michie, Susan, Mograbi, Daniel C, Orrell, Martin William, Paddick, Stella-Maria, Ks, Shaji, Rangawsamy, Thara and Walker, Richard (2019) Mixed methods implementation research of cognitive stimulation therapy (CST) for dementia in low and middle-income countries: study protocol for Brazil, India and Tanzania (CST-International). BMJ Open, 9 (8):e030933. ISSN 0959-8138 (Print), 2044-6055 (Online) (doi:https://doi.org/10.1136/bmjopen-2019-030933)

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Abstract

INTRODUCTION

In low/middle-income countries (LMICs), the prevalence of people diagnosed with dementia is expected to increase substantially and treatment options are limited, with acetylcholinesterase inhibitors not used as frequently as in high-income countries (HICs). Cognitive stimulation therapy (CST) is a group-based, brief, non-pharmacological intervention for people with dementia that significantly improves cognition and quality of life in clinical trials and is cost-effective in HIC. However, its implementation in other countries is less researched. This protocol describes CST-International; an implementation research study of CST. The aim of this research is to develop, test, refine and disseminate implementation strategies for CST for people with mild to moderate dementia in three LMICs: Brazil (upper middle-income), India (lower middle-income) and Tanzania (low-income).

METHODS AND ANALYSIS

Four overlapping phases: (1) exploration of barriers to implementation in each country using meetings with stakeholders, including clinicians, policymakers, people with dementia and their families; (2) development of implementation plans for each country; (3) evaluation of implementation plans using a study of CST in each country (n=50, total n=150). Outcomes will include adherence, attendance, acceptability and attrition, agreed parameters of success, outcomes (cognition, quality of life, activities of daily living) and cost/affordability; (4) refinement and dissemination of implementation strategies, enabling ongoing pathways to practice which address barriers and facilitators to implementation.

ETHICS AND DISSEMINATION

Ethical approval has been granted for each country. There are no documented adverse effects associated with CST and data held will be in accordance with relevant legislation. Train the trainer models will be developed to increase CST provision in each country and policymakers/governmental bodies will be continually engaged with to aid successful implementation. Findings will be disseminated at conferences, in peer-reviewed articles and newsletters, in collaboration with Alzheimer's Disease International, and via ongoing engagement with key policymakers.

Item Type:	Article
Uncontrolled Keywords:	cognition, Alzheimer’s disease, developing countries, quality of life, feasibility
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM) Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Mental Health
Last Modified:	10 Jun 2020 12:00
URI:	http://gala.gre.ac.uk/id/eprint/28132

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