Physical health monitoring in dementia and associations with ethnicity: a descriptive study using electronic health records.

Cini Bhanu,Naaheed Mukadam,Claudia Cooper,Irene Petersen,Rosalind Raine,Kate Walters,Jill Manthorpe,Mary Elizabeth Jones

doi:10.3399/bjgpopen20x101080

Cini Bhanu, Naaheed Mukadam + Show 6 more

Open Access

https://doi.org/10.3399/bjgpopen20x101080

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Journal: BJGP open	Publication Date: Sep 23, 2020
Citations: 2	License type: cc-by

Affiliation: University College London, King's College London

Abstract

BackgroundGood physical health monitoring can increase quality of life for people with dementia, but the monitoring may vary and ethnic inequalities may exist.AimTo investigate UK primary care routine physical health monitoring for people with dementia by: (a) ethnic groups, and (b) comorbidity status.Design & settingA retrospective cohort study was undertaken using electronic primary care records in the UK.MethodPhysical health monitoring was compared in people with dementia from white, black, and Asian ethnic groups and compared those with ≥1 comorbidity versus no comorbidity, from 1 April 2015 to 31 March 2016. Using the Dementia : Good Care Planning framework and expert consensus, good care was defined as receiving, within 1 year: a dementia review; a blood pressure (BP) check (at least one); a GP consultation (at least one); a weight and/or body mass index (BMI) recording (at least one); and an influenza vaccination.ResultsOf 20 821 people with dementia, 68% received a dementia review, 80% at least one BP recording, 97% at least one GP contact, 48% a weight and/or BMI recording, and 81% an influenza vaccination in 1 year. Compared with white people, black people were 23% less likely and Asian people 16% less likely to have weight recorded (adjusted incidence rate ratio [IRR] = 0.77, 95% confidence interval [CI] = 0.60 to 0.98/0.84, 0.71 to 1.00). People without comorbidities were less likely to have weight recorded (adjusted IRR = 0.74, 95% CI = 0.69 to 0.79) and BP monitored (adjusted IRR = 0.71, 95% CI = 0.68 to 0.75).ConclusionEthnic group was not associated with differences in physical health monitoring, other than weight monitoring. Comorbidity status was associated with weight and BP monitoring. Physical health monitoring in dementia, in particular nutrition, requires improvement.

Highlights

Around 850 000 people live with dementia in the UK.[1]
Ethnic group was not associated with differences in physical health monitoring, other than weight monitoring
Comorbidity status was associated with weight and blood pressure (BP) monitoring

Summary

Introduction

Around 850 000 people live with dementia in the UK.[1]. By 2040, this number is likely to increase by 57%.2 People with dementia have high rates of physical morbidities (commonly hypertension and diabetes) that are primarily managed in general practice.[3]. Around 850 000 people live with dementia in the UK.[1] By 2040, this number is likely to increase by 57%.2. In the UK, people from black ethnic groups living with dementia are less likely to be diagnosed, and people from Asian backgrounds less likely to receive symptomatic treatments post-diagnosis, compared with people from white ethnic groups.[9,10] Rates of physical morbidities are higher among people from black and Asian backgrounds compared with the white population,[9,11] so it would be concerning if health inequalities extend to preventive care for physical disorders. Good physical health monitoring can increase quality of life for people with dementia, but the monitoring may vary and ethnic inequalities may exist

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