[People with dementia have more contact with their general practitioners: contact with GPs peaks around the time of diagnosis] (original) (raw)
Related papers
Dementia, 2006
The role of families in supporting people with dementia is widely acknowledged in literature and UK government policy. The role of general practice in ensuring early and effective support for people living with mental health problems including dementia is also enshrined in UK policy. As part of a larger study, a total of 122 carers were asked to rate predefined aspects of the primary care response. For some responses they were also asked to provide a reason for their rating. The purpose of this study was to examine carers' accounts of contacts with general practitioners (GPs) and general practice teams when they were first approached with concerns about their relative. Findings suggest that, on average, carers rate the service as being at least 'good'. However, their accounts describe a wide variety of experiences and demonstrate that expressed satisfaction does not necessarily reflect a satisfactory service. Both practitioner-related and carer-related issues were cited as reasons for their ratings. Implications for practice and research are discussed. de men tia d e m e n t i a
Dementia Care and General Physicians - a Survey on Prevalence, Means, Attitudes and Recommendations
Central European Journal of Public Health
Introduction: General physicians (GP) play a key role in providing appropriate care for people with dementia. It is important to understand their workload and opinions regarding areas for improvement. Material and Methods: A group of 1,109 GPs working in Mecklenburg-Western Pomerania, Gemany (1.633 million inhabitants), were identified, contacted and asked to participate in a written survey. The survey addressed five main topics: (a) the GP, (b) the GP's practice, (c) the treatment of dementia, (d) personal views, attitudes and specific competences regarding dementia and (e) the GP's recommendations for improving dementia-related health care. Results: The survey response rate was 31%. In total, the responding GPs estimated that they provided care to 12,587 patients with dementia every quarter year. The GPs also reported their opinions about screening instruments, treatment and recommendations for better care of dementia patients. Only 10% of them do not use screening instruments, one third felt competent in their care for patients with dementia and 54% opt for transfer of patients to a specialist for further neuropsychological testing. Conclusions: Four conclusions from this study are the following: (a) dementia care is a relevant and prevalent topic for GPs, (b) systematic screening instruments are widely used, but treatment is guided mostly by clinical experience, (c) attitudes towards caring for people with dementia are positive, and (d) GPs recommend spending a lot more time with patients and caregivers and provision of better support in social participation. A majority of GPs recommend abolishing "Budgetierung", a healthcare budgeting system in the statutory health insurance programmes.
2014
A special thank you to the agencies providing funding to undertake the research and to present the findings in Australia, England and Europe, especially Alzheimer's Australia. This organisation supported the research from its conception and provided feedback from staff, volunteers and community members in preparing questionnaires for the research. My sincere thanks to my family, husband Richard Skentelbery, who has tolerated the long hours of study necessary to complete this PhD, and to my children, Nicola and Richard, who have read many of my dissertations with good humour and commented helpfully on my literary efforts and statistical analyses.
Age and Ageing, 2004
Objective: to measure general practitioners' knowledge of, confidence with and attitudes to the diagnosis and management of dementia in primary care. Setting: 20 general practices of varying size and prior research experience in Central Scotland, and 16 similarly varied practices in north London. Participants: 127 general practitioners who had volunteered to join a randomised controlled trial of educational interventions about dementia diagnosis and management. Methods: self-completion questionnaires covering knowledge, confidence and attitudes were retrieved from practitioners prior to the educational interventions. Results: general practitioners' knowledge of dementia diagnosis and management is good, but poor awareness of its epidemiology leads to an overestimate of caseload. Knowledge of local diagnostic and support services is less good, and one third of general practitioners expressed limited confidence in their diagnostic skills, whilst two-thirds lacked confidence in management of behaviour and other problems in dementia. The main difficulties identified by general practitioners were talking with patients about the diagnosis, responding to behaviour problems and coordinating support services. General practitioners perceived lack of time and lack of social services support as the major obstacles to good quality care more often than they identified their own unfamiliarity with current management or with local resources. Attitudes to the disclosure of the diagnosis, and to the potential for improving the quality of life of patients and carers varied, but a third of general practitioners believed that dementia care is within a specialist's domain, not that of general practice. More experienced and male general practitioners were more pessimistic about dementia care, as were general practitioners with lower knowledge about dementia. Those reporting greater difficulty with dementia diagnosis and management and those with lower knowledge scores were also less likely to express attitudes endorsing open communication with patient and carer. Conclusion: educational support for general practitioners should concentrate on epidemiological knowledge, disclosure of the diagnosis and management of behaviour problems in dementia. The availability and profile of support services, particularly social care, need to be enhanced, if earlier diagnosis is to be pursued as a policy objective in primary care.
PubMed, 2018
Aims Most of those with a memory problem or concern over cognition present to their General Practitioner (GP) in the first instance. Despite this, the current diagnostic and referral patterns of Irish GPs remains unclear. Methods A survey was distributed to three separate cohorts of GPs (n=692) Results Ninety-Five (14%) responded. Most personally diagnose 1-3 (69%; 65/95) or 4-6 (21%; 20/95) patients with dementia per year. Two-thirds (62%; 59/95) refer >80% of those with possible dementia for further assessment/support, most commonly to support/clarify a diagnosis (71%; 67/95) and most frequently to a geriatrician (79%; 75/95). In half of cases (51%; 48/95), referral is to a professional working as part of an established memory clinic. One-fifth reported receiving dementia-specific postgraduate training (19%; 18/95) and over four-fifths (82%; 78/95) would welcome further training. Discussion Further attention to the ongoing establishment of memory clinic services and dedicated referral pathways, as well as increasing emphasis on dementia assessment and diagnosis in medical curricula, is warranted.
2011
Background Management of neuropsychiatric symptoms is a challenging task in primary care. Aims To assess self-reported confidence and knowledge of general practitioners (GPs) regarding the identification and management of behavioural and psychological symptoms of dementia (BPSD).Methods A self-designed two-page paper questionnaire was sent to a random sample of 160 GPs practising in north Dublin. They were asked to evaluate their confidence and knowledge on several aspects of diagnosis and management of BPSD.Results Completed questionnaires were returned from 109 GPs (response rate = 68%), of which 106 were usable. In general, GPs were somewhat critical of their self-reported skills in diagnosing (76.4%) and managing (77.4%) BPSD, as well as in discriminating BPSD from other behavioural disturbances (71.7%). Many of them (67.9%) also encountered difficulty accessing specialist services. There was no correlation between demographic characteristics of GPs or patient caseload with resp...
Diagnosing dementia in Dutch general practice: a qualitative study of GPs' practices and views
The British journal of general practice : the journal of the Royal College of General Practitioners, 2016
GPs play an important role in recognising the symptoms of dementia; however, little is known about how they perceive their actual and future role in diagnosing dementia. To explore Dutch GPs' perceptions of their current position in diagnosing dementia, their reasons for referral to secondary care, and views on the future diagnostic role of GPs. A qualitative study among Dutch GPs. Eighteen GPs participated in a semi-structured interview that ranged from 20 to 60 minutes. Interviews were transcribed verbatim and thematic analysis was performed. GPs reported that their role in the diagnostic phase of identifying people with suspected dementia is limited to recognising cognitive problems and deciding whether a patient needs to be referred for further investigation, or whether care could be organised without specialist diagnosis. GPs indicated that they were likely to refer patients if patients/caregivers or dementia case managers requested it, or if they thought it could have cons...
Dementia in primary care: the first survey of Irish general practitioners
International Journal of Geriatric Psychiatry, 2006
Objective To investigate General Practitioners' (GPs) attitudes and practices in relation to screening, diagnosing, and disclosing a dementia diagnosis to patients. Design National postal survey. Participants A random sample of 600 GPs from a national database of 2400. Results Of the 600 GPs surveyed, 60% returned questionnaires of which 50% (300) were useable. GPs reported diagnosing on average four new cases of dementia annually. A multivariate analysis revealed that females diagnosed significantly fewer cases annually (t ¼ 5.532, df ¼ 289, p < 0.001). A large majority of GPs reported performing thyroid function tests (77%), B 12 (75%) and Folic acid tests (75%) to out rule reversible causes of cognitive impairment. The most reliable signs and symptoms of dementia identified were memory problems (58%). Main barriers to diagnosis were difficulty differentiating normal ageing from symptoms of dementia (31%), lack of confidence (30%) and the impact of the diagnosis on the patient (28%). GPs' age ( 2 ¼ 14.592, df ¼ 3, p < 0.005) and gender ( 2 ¼ 11.436, df ¼ 3, p < 0.01) were significantly associated with barriers to diagnosis. Only 19% claimed they often or always disclosed a diagnosis to a patient. Over one-third of GPs (38%) reported that the key factor influencing their disclosure patterns was their perceptions of the patient's level of comprehension. Most GPs (90%) had never undergone any dementia specific training and most (83%) expressed a desire for this. Conclusions GPs experience difficulty diagnosing and disclosing a diagnosis of dementia to patients. To improve dementia care in Ireland, there is an urgent need to develop an active and more systematic approach to GP training in dementia care.
Dementia: opportunities for risk reduction and early detection in general practice
Australian Journal of Primary Health, 2011
This project aimed to measure general practitioner (GP), practice nurse and patient health literacy about memory problems, dementia and its risk factors. Data were collected from general practices across Australia and a smaller sample in England. Questionnaires explored sources and adequacy of dementia knowledge and a randomised controlled trial tested the intervention of a dementia risk reduction pamphlet on patient knowledge of dementia risk reduction strategies. Data were analysed using SPSS software. The results of 621 questionnaires from patients aged over 30 years showed 37% had memory concerns, 6% recalled having a memory test, 52% would like a memory test and 15% had heard about dementia from their GP. Patients receiving the intervention were significantly more likely to be aware of dementia risk reduction strategies (P ≤ 0.005). The results of 153 GP/nurse questionnaires indicated 64% thought a doctor should discuss dementia with patients despite only 21% assessing their de...