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Flare in knee and hip osteoarthritis (OA) is more than just an exacerbation of pain. Unstructured, semistructured, and focus group interviews followed by Delphi surveys with patients and health professionals (HP) generated candidate domains of an OA flare. Content analysis of interviews with 29 patients and 16 HP extracted 180 statements, which were grouped into 9 clusters. Delphi consensus with 50 patients (Australia, Canada, and France) and 116 HP (17 countries on 4 continents) identified 5 flare domains: pain, swelling, stiffness, psychological aspects, and effect of symptoms. Elements for a preliminary definition of an OA flare are proposed. Registered at clinicaltrials.gov NCT02892058.

This paper aimed to develop a model to describe help-seeking for dementia diagnosis. The practical model is intended to guide public health interventions to increase help-seeking. The model was developed by our multidisciplinary team based on qualitative semi-structured interviews in English (n = 33) and Chinese (n = 8) with older people, people with dementia and carers. The model was also informed by systematic reviews on help-seeking for dementia diagnosis, theories of help-seeking and further iterated based on feedback from a co-design group (n = 10). The model starts with changes which might be symptoms of dementia being observed by the person or family/friends and ends in dementia assessment. Model steps are (1) The person deciding that the changes represent a health problem; (2) obtaining support or confirmation from family/friends that the changes are a health problem; (3) deciding to seek medical help; and (4) persuading the GP to facilitate dementia assessment. The model applies to English and Chinese-speaking Australians, though there were additional barriers for Chinese speakers. There are personal, family, community and health system barriers at each step. Interventions to improve diagnosis of dementia might target public knowledge of dementia symptoms and benefits of a diagnosis, and general practice.

Background and Objectives: Recently, cost-benefit analysis has been increasingly used to evaluate the value of interventions for dementia. This study aims to synthesize the methodology used in cost-benefit analysis (CBA) for dementia interventions. Research Design and Methods: We conducted a scoping review with comprehensive systematic searches for original peer-reviewed articles published from January 2010 to December 2023, and included the studies if they (1) performed a CBA of interventions for dementia, (2) described either cost or benefit items, and (3) performed quantitative data analysis on either costs or benefits. The review adhered to the PRISMA Extension for Scoping Reviews Checklist to write the report. Results: Of the 3415 articles found from the search, 15 were included in the review. Data analysis included the traditional CBA approach and its integration with the social return on investment approach. The set of cost and benefit items may vary depending on the intervention. Staff training, intervention supplies, building hire, and transportation were common cost items. Quality-adjusted life years (QALY), general practitioner visits, and emergency room visits were common benefit items. Cost data were often sourced from the study budget/assumptions. Benefit data were often sourced from the social value banks and literature. Market and shadow pricing were used for cost valuation. The value of statistical life was frequently used for benefit valuation. Discussion and Implications: This review synthesized data analysis methods, lists of cost and benefit items, data sources, and valuation methods used in the CBA of interventions for dementia. The findings provide helpful information for considering methodology in future CBA of interventions for dementia and similar interventions or conditions.

Objectives: This study aimed to conduct a feasibility pilot of the Dementia Lifestyle Coach program; an individual coaching and counselling program for people recently diagnosed with dementia, to help them to adjust to the diagnosis and live well. Methods: A randomised controlled pilot trial (n = 11) with wait-list control group was undertaken over 12 months. Intervention group participants received immediate personalised counselling from a registered psychologist and monthly support (face-to-face or by telephone) from a trained peer mentor living with dementia. The wait-listed control group commenced treatment 6 months after baseline. Results: Recruitment and delivery of the Dementia Lifestyle Coach program was highly feasible. The program was acceptable, with nine of the 11 participants describing benefits including informational and emotional support, improving their outlook and mood, and family relationships. The planned program was adapted to participants' individual needs. Conclusions: This small pilot showed that it is feasible to recruit for and deliver a counselling and peer mentoring program for people recently diagnosed with dementia. A larger hybrid implementation randomised control trial should be conducted to evaluate efficacy and effectiveness.