Recommendations of the Canadian Consensus Conference on Dementia - Dissemination, implementation, and evaluation of impact

Background: Subsequent to the development of consensus statements on a clin ical topic, it is vital to establish a plan for dissemination, implementati on and evaluation of impact. Consensus statements can be used for both guid ing continuing medical education (CME) and producing clinical practice guid elines (CPGs). Insufficient attention to dissemination can lead to a failur e to change physician behaviour and improve patient outcomes. Methods: A pl an to disseminate the conclusions of the Canadian Consensus Conference on D ementia (CCCD) was developed. This plan was based on a literature review of CME and CPGs. A Medline search was performed on the dissemination and eval uation of the 1989 Canadian Consensus Conference on the Assessment of Demen tia (CCCAD) and other published guides for physicians on dementia care. CCC D dissemination that has occurred to date (June, 2000) was reviewed in this paper. Results: Lectures and unsolicited printed material are weak forms o f CME. Small-group interactive CME that provides practice opportunities app ears to be the most effective way to change physician behaviour. The abilit y of CPGs to change physician behaviour is uncertain. It appears that inade quate attention has been placed on CPG dissemination and implementation. Th e CCCAD had a modest impact on clinical practice in Canada. While dissemina tion of the conclusions of the CCCD has taken place, evaluation of the impa ct of the CCCD has yet to be done. Local initiatives utilizing the conclusi ons of the CCCD are on-going. Conclusions: Further work is needed on how to optimize the impact of consensus statements and CPGs. While dissemination of the CCCD has occurred. it is currently unknown whether it has led to any change in physician practices.