Framing Primary Care Clinicians’ Experiences Managing Behavioral and Psychological Symptoms of Dementia: Insights From an Educational Intervention

Tammi Albrecht, DNP; Tamara J. LeCaire, MS, PhD; Molly Schroeder, CSW; Jonathan Stone, MD; Uriel Paniagua, MPH; Sylvia Peng, BS; Jennifer Landeta Vidal, MPH; Stephanie Houston, MBA; Sarina Schrager, MD, MS; Cynthia M. Carlsson, MD, MS; Art Walaszek, MD

WMJ. 2026;125(1):210-216.

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ABSTRACT

Introduction: Approximately 90% of persons with dementia experience behavioral and psychological symptoms of dementia (BPSD). Primary care clinicians often are the main health care professionals managing the care of persons with dementia who exhibit BPSD, yet many lack training and resources needed for management. DETAILD (Dementia Educational Techniques: Academic detaILing and DICE) is an educational intervention designed to enhance clinicians’ knowledge, confidence, and implementation of evidence-based practices for recognizing and managing BPSD.

Objectives: This study aimed to identify clinician-level factors that influence the reach, adoption, implementation, and effectiveness of the DETAILD intervention in supporting primary care clinicians in managing BPSD.

Methods: Semistructured qualitative interviews were conducted with 14 clinicians. A framework-guided analysis was used to identify knowledge and practice gaps in BPSD management and factors that affect engagement with the DETAILD program.

Results: Clinicians identified gaps in knowledge and self-efficacy related to recognizing and managing BPSD, particularly in applying nonpharmacologic strategies and care planning. Eleven themes emerged that influenced DETAILD’s reach, adoption, implementation, and effectiveness, including the need for personalized care approaches, team-wide buy-in, applied learning methods, and training logistics. Clinicians emphasized the benefits of case-based learning and the need for flexible formats and foundational knowledge.

Conclusions: Findings highlight significant gaps in knowledge, confidence, and resources related to BPSD management among primary care clinicians. Identified barriers and facilitators informed adaptations to the DETAILD intervention aimed at enhancing clinician engagement, supporting practice change, and ultimately improving dementia care within primary care settings.

Author affiliations: University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, Wisconsin (Albrecht, Carlsson, Houston, LeCaire, Paniagua, Peng, Schrager, Schroeder, Stone, Vidal, Walaszek); Wisconsin Alzheimer’s Institute, Madison, Wisconsin (Albrecht, Carlsson, Houston, LeCaire, Schroeder, Vidal, Walaszek); Wisconsin Research and Education Network, Madison, Wisconsin; Department of Family Medicine and Community Health, UWSMPH, Madison, Wisconsin (Schrager).
Corresponding author: Tammi Albrecht, DNP, Wisconsin Alzheimer’s Institute, 610 Walnut St, 9th floor WARF Building, Madison, WI 53726; email tjalbrecht@wisc.edu; ORCID ID 0009-0009-7947-0438
Financial disclosures: Art Walaszek receives book royalties from the American Psychiatric Association Publishing for Behavioral and Psychological Symptoms of Dementia, Late-Life Depression and Anxiety, and Substance Use in Older Adults.
Funding/support: This project was funded by UW-Madison Institute for Clinical and Translational Research with support from NIH-NCATS Clinical and Translational Science Award (CTSA) 1UL1TR002373, Wisconsin Partnership Program at UW-Madison, Wisconsin Partnership Program (WPP 5129), and Wisconsin Alzheimer’s Institute. Slyvia Peng received support from the Herman and Gwendolyn Shapiro Foundationfor a summer research award.
Data statement: A sample of these data has been previously presented in posters at Alzheimer’s Association International Conference and manuscript in Implementation Science Communications, which is referenced in this manuscript. The datasets generated and analyzed during the current study are not publicly available to protect study participant privacy. Summary data are available from the corresponding author on reasonable request.

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