Barriers and Facilitators to Implementing Cognitive Stimulation Therapy (CST) in Ireland: A Qualitative Study Exploring Perspectives of Healthcare and Policy Professionals

Background: Cognitive Stimulation Therapy (CST) is one of the most highly recommended non-pharmacological interventions for people living with dementia. In Ireland, over 650 practitioners have been trained to deliver CST; however, the intervention is not routinely available as a post-diagnostic support. The objective of this study was to identify barriers and facilitators to implementation of CST within the healthcare system in Ireland, through interviews with healthcare and policy professionals. Methods: Semi-structured interviews were conducted with 10 key stakeholders involved in the provision of dementia services in Ireland, either in a policy role (n = 5) or as a healthcare professional (n = 5). Participants were responsible for the leadership of a dementia service and/or the direct provision of clinical care. Data collection and analysis was guided by the Consolidated Framework for Implementation Research (CFIR). Framework analysis was used to identify themes that illustrated key barriers and facilitators to the implementation of this intervention in an Irish context. Results: Findings were organised into five themes: Familiarity, Understanding, and Evidence; Partnerships and Connections; Policy; Resources; and Attitudes and Culture. These themes illustrated barriers and facilitators to implementation operating at the Innovation, Outer Setting, and Inner Setting CFIR domains. Conclusion: Identifying and addressing key barriers and facilitators to the implementation of CST within the Irish healthcare system may help to support successful implementation and sustained use of the intervention in future. The CFIR provides a useful framework for conceptualising pre-implementation barriers and facilitators. The findings of this study can be used to develop specific implementation strategies and/or models to increase the availability of CST in Ireland.