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Using implementation science to progress psychogeriatrics

It is my continuing pleasure to be the guest editor for this second special issue of International Psychogeriatrics focused on Implementation Science. As a field, and as a global society, we are still grappling with the ongoing uncertainties and effects of COVID-19. This highlights more than ever the need to work towards implementing our best science into practice in the service of the mental health needs of older persons. As illustrated in the first special issue focused on Implementation Science, the means and the efficacies of translating knowledge into practice can be empirically evaluated; this in turn provides an important contribution to both research agendas and clinical practice and policy considerations. This second special issue includes a similarly diverse range of articles on implementation science in the field of psychogeriatrics. Each article is accompanied by a commentary by an expert in the area, to add another dimension to, and illuminate the context of, the topic under discussion. The articles span two broad areas: issues of assessment and aspects of interventions. But first we have two review articles. A systematic review by Groot Kormelinck et al. (2021) describes barriers and facilitators influencing the implementation of complex interventions targeting neuropsychiatric symptoms and psychotropic drug use in long-term care. A key finding of their review is that communication and coordination between disciplines, management support, and culture positively influence implementation. The commentary by Dozier (2021) highlights the key role that communication plays in successful implementation within long-term care settings. The key organizational barriers to implementation, namely instability within teams, facilities, and organizational structures, illustrate that even optimal communication can be trumped by an unstable environment. The review article of Karnatz et al. (2021) presents a scoping review of the characteristics, challenges, and unmet needs of caregivers, and possible interventions for this underserved patient population. Their results demonstrate that caregivers of patients with FTLD are often younger in age, have children at home, and find behavioral disturbances encountered to be the most burdensome aspect of caregiving. With respect to interventions, the support structures for FTLD caregivers should be assessed and extended. Both Karnatz et al. (2021) and the commentary by Chick and O’Hara (2021) underscore that awareness both in the wider population and among healthcare professionals is an urgent need for the future with respect to caregivers of patients with FTLD. With respect to assessment, Peisah et al. (2021) describe development of an inclusive curriculum for a capacity education e-tool with cross-disciplinary relevance. The tool was tested in three countries (Australia, Canada, and Israel) across a wide range of healthcare professionals, whose scores significantly increased after use of the e-tool. As Palmer (2021) states in his commentary, capacity is a singularly vexing issue for healthcare professionals, given that many have inadequate training in this area and given the high stakes for patients that many capacity questions raise. Quality of life (QoL) is an important parameter to measure in persons living with dementia. The article by Hughes et al. (2021) reviews existing dementiaspecific QoL measures developed or validated for use in care settings. The methodological quality of the studies was assessed using the COSMIN checklist. Disappointingly, higher-quality instruments were not easily accessible or had low feasibility of use. In their commentary, Madsø and Nordhus (2021) propose an alternate approach to developing a proliferation of QoL measures, namely development of item banks based on item response theory (Edelen and Reeve, 2007), where generic questions are applicable for a variety of populations (see for e.g. PROMIS (healthmeasures.net)). Such item banks are created to ensure optimal scalability of items, where each item corresponds to a level of quality of life. In practice, the item bank is adjusting to the individual and terminates the questionnaire when the QoL level is identified. Three researchers contributed work on interventions and their implementation to this special issue. Gerritsen et al. (2021) describe a process evaluation of a multidisciplinary biannual medication review (the PROPER intervention) in six Dutch long-term International Psychogeriatrics (2021), 33:9, 847–849 © International Psychogeriatric Association 2021