Abstract
SummaryStudies have shown that primary care is not always effective when it comes to caring for people with dementia. In addition, general practitioners do not always use diagnostic instruments consistently. The aim of the study was to identify relevant factors that influence general practitioners’ attitudes and willingness with respect to consistent diagnosis and care. For this purpose, resources, viewpoints, and behavioral patterns of general practitioners with regard to dementia diagnostics as well as common challenges in everyday practice were recorded. In the course of a survey, a total of 2266 general practitioners in Hesse and Baden-Württemberg were interviewed between January and March 2020. In addition to the descriptive analysis, a t-test was used to determine significant differences between two groups. A univariate linear regression analysis was carried out to identify possible influencing factors. 81% of the respondents do provide dementia diagnostics; 51% are involved in the treatment. Most of them see the diagnostic work-up (77%), communication and compliance problems (73%), as well as the therapeutic support (71%) as common challenges. In addition, there are interface problems regarding the interdisciplinary cooperation. Some of the respondents express doubts about the value of early detection (41%). The general practitioners’ attitude with respect to dementia diagnostics and care is determined by influencing factors that relate to geriatric competencies, expectations of self-efficacy, the integration of practice staff, as well as the knowledge of and cooperation with counseling and care services. It seems advisable to strengthen the geriatric competence of general practitioners. Moreover, it appears essential to educate general practitioners more about support structures in the field of dementia care and to integrate them accordingly. In addition, practice staff should be more systematically involved in the identification and care of dementia patients.Supplementary InformationThe online version of this article (10.1007/s10354-020-00803-9) contains supplementary material, which is available to authorized users.
Highlights
General practitioners have often known patients for years who come to their consultations on a regular basis, so the general medical practice setting provides favorable conditions for identifying changes in cognitive condition in a timely manner [1,2,3]
The general practice provided dementia diagnostics according to 81% of general practitioners
A greater share of respondents without any dementia diagnostics in their own general practice felt substantially less capable of diagnosing dementia on time compared to the other respondents (63% compared to 16%; α = 0.001; p = 0.0)
Summary
General practitioners have often known patients for years who come to their consultations on a regular basis, so the general medical practice setting provides favorable conditions for identifying changes in cognitive condition in a timely manner [1,2,3]. This gives general practitioners a key role in identifying and treating patients with dementia [4, 5]. Apart from that, one study in a model project for outpatient dementia care has shown that most general practitioners prefer to leave diagnosis (according to guidelines) to specialists [6]. Two interview studies found that a significant number of responding general practitioners tended to refer dementia patients to specialists as fast as possible and scarcely participated in the healthcare process [16, 17]
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