The practice staff in primary care dementia recognition-is there an untapped potential?

Abstract

It is regularly criticized that the diagnostics of dementia are not used effectively and consistently enough in general practitioner (GP) care. An important component for the optimization of early detection is the targeted training and involvement of the practice staff. To date, there is alack of studies that capture the extent to which primary care personnel are actually integrated into dementia recognition and how they assess their own potential to contribute to amore efficient diagnosis of dementia. The study was based on 45 qualitative individual interviews with GP practice personnel in Rhineland-Palatinate and Hesse, which were conducted orally and personally between November 2017 and June 2018 (duration: 25-70 min). The results show that GP personnel showed agreat willingness to support the family doctor in dementia recognition and diagnostics; however, this potential is only partly used in primary care practices. Most of the sample showed marked uncertainties in assessing possible signs of incipient dementia. This corresponds to the fact that only aminority of the interviewees had ever completed training in which dementia was an important topic. The identification of dementia patients by the practice employees seems to function according to the random principle and less according to systematic criteria. The analysis showed that many GPs are not yet aware of the opportunities offered by agreater involvement of practice personnel in the recognition of dementia. Accordingly, GPs should be advised of the benefits of such asolution. At the same time, more attention should be paid to low-threshold training formats, which are tailored specifically to the perspective of practice employees and convey important dementia-specific diagnostics, action and communication skills.