The use of self-management techniques in patients with mild cognitive impairment Devon Partnership NHS Trust

A team from Devon Partnership NHS Trust has looked at whether self-management techniques that have been shown to be effective in people with depression could help patients with mild cognitive impairment (MCI).

MCI is a condition where someone has memory and/or other cognitive deficits that are greater than expected, but that are not severe enough for them to be diagnosed with dementia. Patients with MCI are at high risk of developing dementia in the future. While no disease-modifying treatments currently exist for people with MCI, there is evidence that lifestyle changes can reduce the risk of progression to dementia.

This project involved developing and running group sessions (facilitated by occupational therapists from the community mental health team) for MCI patients that teach self-management skills to help them with their day-to-day lives and help them reduce their risk factors for conversion to dementia. Each session focused on a different risk factor, for example regular exercise, mental stimulation and stress management, and concentrated on patient-derived goal setting and action planning.

Over the course of the project nine groups ran, with 49 patients and their friends/relatives successfully completing the programme. There was a statistically significant improvement in the ‘Patient Activation Measure’ – a well-validated tool that assesses a patient’s confidence to self-manage their condition when comparing the start and end of the groups. There was also evidence of a rise in their awareness of the risk factors for conversion to dementia, leading to an increase in the skills and knowledge needed for them to make healthy changes to their lifestyle. However, one of the main challenges was sustaining this over the longer term. The next step is to explore wider spread of the project with a national partner.

Supporting dissemination

This project was given further support through a Spreading Improvement grant to help disseminate learning and maximise the impact of the approach across the health service.

Funding will be used to demonstrate that the THYMe self-management groups can be successfully delivered by the voluntary sector,  using Age UK in South Devon and Exeter as demonstration sites. Age UK workers will be trained to deliver the THYMe programme, and a downloadable train-the-trainers web course will produced.

Contact details

For more information about the project, please email David Pearce at Devon Partnership NHS Trust.