Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol

Hannah Wheat, Lauren Weston, Tomasina M. Oh, Sarah Morgan-Trimmer, Wendy Ingram, Sarah Griffiths, Rod Sheaff, Paul Clarkson, Antonieta Medina-Lara, Crispin Musicha, Stuart Spicer, Obioha Ukoumunne, Victoria Allgar, Siobhan Creanor, Michael Clark, Cath Quinn, Alex Gude, Rose McCabe, Saqba Batool, Lorna SmithDebra Richards, Hannah Shafi, Bethany Warwick, Reena Lasrado, Basharat Hussain, Hannah Jones, Sonia Dalkin, Angela Bate, Ian Sherriff, Louise Robinson, Richard Byng

Research output: Contribution to journalArticlepeer-review


Background: Different dementia support roles exist but evidence is lacking on which aspects are best, for whom, and in what circumstances, and on their associated costs and benefits. Phase 1 of the Dementia PersonAlised Care Team programme (D-PACT) developed a post-diagnostic primary care-based intervention for people with dementia and their carers and assessed the feasibility of a trial. Aim: Phase 2 of the programme aims to 1) refine the programme theory on how, when, and for whom the intervention works; and 2) evaluate its value and impact. Design & setting: A realist longitudinal mixed-methods evaluation will be conducted in urban, rural, and coastal areas across South West and North West England where low-income or ethnic minority populations (for example, South Asian) are represented. Design was informed by patient, public, and professional stakeholder input and phase 1 findings. Method: High-volume qualitative and quantitative data will be collected longitudinally from people with dementia, carers, and practitioners. Analyses will comprise the following: 1) realist longitudinal case studies; 2) conversation analysis of recorded interactions; 3) statistical analyses of outcome and experience questionnaires; 4a) health economic analysis examining costs of delivery; and 4b) realist economic analysis of high-cost events and ‘near misses’. All findings will be synthesised using a joint display table, evidence appraisal tool, triangulation, and stakeholder co-analysis. Conclusion: The realist evaluation will describe how, why, and for whom the intervention does or does not lead to change over time. It will also demonstrate how a non-randomised design can be more appropriate for complex interventions with similar questions or populations.

Original languageEnglish
JournalBJGP Open
Issue number3
Publication statusPublished - 19 Sept 2023


  • caregivers
  • dementia
  • personalised care
  • primary health care
  • realist evaluation


Dive into the research topics of 'Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol'. Together they form a unique fingerprint.

Cite this