Improving how sleep problems are identified and managed in primary care by co‑developing tailored support for people with dementia, mild cognitive impairment and their carers.
Why the research is needed?
Sleep disturbance often affects people living with dementia or mild cognitive impairment, impacting their daily activities and leading to carer fatigue. People often ask their doctor for medicines to help with sleep, but sleep medicines used long-term can be harmful or stop working. Help needs to be tailored to the individual. Many different things can upset sleep. For some people, non-medicine treatments, given either on their own or in combination with tablets, may be better. Different people need different approaches to help. Doctors, patients and carers should work together for the best tailored care but have told us they need help to do that.
What are we doing?
TIMES is a co-designed intervention to help patients, carers and professionals produce tailored care plans that meet the sleep-related needs of people with dementia or memory problems and their carers, whilst reducing harm from sleeping medicines. To understand how the intervention should be designed, we are using a realist review, focus groups, consultation, and observation to design the TIMES pathway. To understand whether it works, we will test the intervention in a national trial, involving 420 patients and carers from 66 GP practices in England.
How are we working with communities, services and organisations?
The study has been co-designed, with input from people with lived experience, clinicians from primary and secondary care and academics. We work with numerous Patient and Public Involvement groups involving carers and people with dementia and cognitive impairment, and ethnic minority groups.
What will the impact and benefits of this research be?
This research will help us better understand how to identify and manage sleep problems for people with dementia, mild cognitive impairment, their carers and healthcare professionals in primary care. TIMES will develop a new pathway to improve care and strengthen primary care practice in dementia. If the small trial is successful, a larger trial will follow to determine whether the new tool is beneficial for patients and carers.
What do we have planned for knowledge mobilisation and implementation?
Findings are shared with patients and public through newsletters, TIMES website and social media, and we regularly present our findings at leading international conferences.
We will produce summaries for different audiences. DEEP, Alzheimer’s Society and TIDE members will help us prepare and share resources videos for patients and carers that help them access tailored sleep care. We will inform professionals through academic and professional journals, conferences, events, and social media. We will hold workshops for people with dementia or memory problems, carers, prescribers, and people who decide on and provide health and social care services, to share our findings.
Related papers, outputs and resources
Click to view the TIMES website
Read the related article titled, 'Sleep disturbance in people living with dementia or mild cognitive impairment: a realist review of general practice'
Read the related article, titled 'TaIlored ManagEment of Sleep (TIMES) for people with dementia and mild cognitive impairment in primary care in England: protocol for a feasibility cluster-randomised controlled trial'
Who is involved?
- Professor Chris Fox, University of Exeter and Norfolk and Suffolk NHS Foundation Trust
- Dr Jayden van Horik, University of Exeter
- Dr Anne Killett, University of East Anglia
- Dr Sion Scott, University of East Anglia and University of Leicester
- Professor Gill Livingston, University College London
- Geoff Wong, University of Oxford
- Professor Clive Ballard, University of Exeter
- Professor Ian Maidment, Aston University
- Professor Antonieta Medina-Lara, University of Exeter
- Professor Louise Allan, University of Exeter
- Dr Andrea Hilton, University of Hull
- Professor Joanne Reeve, University of Hull
- Alpar Lazar, University of East Anglia
- Professor Lee Shepstone, University of East Anglia
- Ms Rachael Litherland, Innovations in Dementia
- Mizanur Khondoker, University of East Anglia
- Mr George Rook, Public and Patient Involvement Lead
- Professor Niall Broomfield, University of East Anglia
- Professor Yoon Loke, University of East Anglia
- Dr Christopher Buckingham, Aston University
- Dr Julian Brown, General Practitioner, Litcham Health Centre
- Mr George Rook, Person Living With Dementia
Get in contact
Email Professor Chris Fox or the project team at christopher.fox@exeter.ac.uk or TIMES@exeter.ac.uk.
