General practitioners facing dementia: are they fully prepared?

Pucci, Eugenio; Angeleri, F; Borsetti, Gabriele; Brizioli, E.; Cartechini, Elisabetta; Giuliani, Giuliana; Solari, Alessandra

doi:10.1007/s10072-003-0193-0

Cited by 41 publications

(41 citation statements)

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“…The gender difference was similar to studies reported elsewhere (Kaduszkiewicz, Wiese, & van den Bussche, 2008;Pucci et al, 2003) and corresponds to the actual representation of female physicians in the overall Maltese GP population. Most of the GPs (73.6%) indicated that they had 15 years or more working experience in general practice.…”

Section: Resultssupporting

confidence: 88%

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Practices in diagnosis, disclosure and pharmacotherapeutic management of dementia by general practitioners – a national survey

Caruana-Pulpan

Scerri

2013

Aging & Mental Health

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Section: Resultssupporting

confidence: 88%

“…This continues to add on previous literature (e.g. Connolly et al, 2011;Pucci et al, 2003;Valcour, Masaki, Curb, & Blanchette, 2000).…”

Section: Discussionsupporting

confidence: 68%

Practices in diagnosis, disclosure and pharmacotherapeutic management of dementia by general practitioners – a national survey

Caruana-Pulpan

Scerri

2013

Aging & Mental Health

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“…A wide variation in primary care physicians' abilities and confidence in diagnosing and managing dementia has been consistently reported (O'Connor et al, 1988;Downs et al, 2000), a finding that is consistent across different countries (Pucci et al, 2004). This problem of under-diagnosis is probably not due to lack of diagnostic skills, but rather to the interaction of case-complexity, pressure on time and the negative effects of reimbursement systems (Hinton et al, 2007;Stoppe et al, 2007a).…”

Section: Making the Diagnosis Of Dementiamentioning

confidence: 96%

Primary care and dementia: 1. diagnosis, screening and disclosure

Iliffe

Robinson

Brayne

et al. 2009

Int J Geriat Psychiatry

167

154

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SUMMARYObjectives To write a narrative review of the roles of primary care practitioners in caring for people with dementia in the community. Methods The systematic review carried out for the NICE/SCIE Guidelines was updated from January 2006, Cochrane Reviews were identified, and other publications found by consultation with experts. Results The insidious and very variable development of dementia syndromes makes recognition of the syndrome problematic in primary care. Dementia is probably under-diagnosed and under treated with an estimated 50% of primary care patients over 65 not diagnosed by their primary care physicians. This problem of under-diagnosis is probably not due to lack of diagnostic skills, but rather to the interaction of case-complexity, pressure on time and the negative effects of reimbursement systems. Primary care physicians often over-estimate the prevalence of dementia syndromes, but in some countries may also overestimate the prevalence of vascular dementia compared with Alzheimer's disease. Diagnosis is a step-wise process which can be aided by use of a cognitive function test, of which there are a number suitable for primary care use. Evidence based practice protocols can enhance detection rates in primary care, and there is growing evidence that communication skills in talking to people with dementia about dementia can be improved. Nevertheless there are multiple obstacles to bringing recognition forward in time, both in public awareness and professional understanding of the early changes in dementia. Conclusions There is insufficient evidence of benefit to justify population screening in primary care but earlier recognition of people with dementia syndrome is possible within primary care. The diagnosis of dementia is a shared responsibility between generalist and specialist disciplines. Primary care physicians should explore patients' ideas and concerns around their symptoms prior to referral and tentatively discuss possible diagnoses. Once the diagnosis has been confirmed, the primary care physician should provide both practical and emotional support to allow the patient and their family to come to terms with living with dementia, and refer them for additional psychosocial support if required.

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“…Dementia can show vary from one person to another but over longer periods it makes the person more disabled [2]; [3] and challenges for primary care to detect for both caregivers and general practitioner and multidisciplinary team in their practice. It is a rapidly increasing as common public health issue all over the world that is under recognized in primary care settings [4]; [5] finds that primary care physicians fail to recognize, findings & proper managements. Therefore, dementia and related disorder disease pose a significant public health issue.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Doctor’s Clinical Practice, Confident And Difficulties To Manage And Care For Dementia In Remote Area Hospital

Pathak

Montgomery

2017

JBTM

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Objectives: To examine multidisciplinary doctor's clinical practice, confident and difficulties to manage and care for dementia in remote area hospital. Method:A structured self-completed questionnaire, purposive sampling method with 18 multi-specialist doctors from united mission hospital.Results: Key findings are dementia is a complex condition to diagnose and management that takes time to diagnose and current dementia assessment process is conflict between GPs and other professionals. As well as specialist did not consider that diagnosing dementia was benefited, nor current applied diagnostic methods are appropriate and they are skeptical about the advantages of dementia medications and methods which they have practice on primary care. Similarly, GPs detection is not final decision therefore better to make collaboration with others specialist professionals-neither confident to diagnose nor easy to get medicine in the local market.Likewise, neither social support nor day care and memory clinic services are available in the community. Lack of epidemiology knowledge, practice and experience, cost of dementia care, no governmental policy, no early diagnosis are additional barriers aspects to reach accurate diagnosis. Conclusions:Still the diagnostic methodology and practice has not similar to screening dementia so it does not seem significantly benefit in screening. Rather early diagnosis, collaboration with multi specialist doctors, appropriate referral pathways, diagnostic guideline and refined MMSE tool is far better. It is not only issue of primary care doctors'-and not possible to detect the dementia without collaboration of multi experts group. The burden impact of dementia prevalence has been underestimated in developing countries. DOI DesignPurposive sampling method was used to achieve the objectives and it was conducted after the taking permission using self-completed question (English version) set with the specialist doctors in hospital. All these questions were both distributed and collected by the hospital director and it was collected after the information by the same director with in one months of the distributed date. There was not any bias to distribute the questions to the specialist. It was requested to complete questionnaire set according to their own current knowledge but not taking any support from out.These question set were distributed for those specialists only who were wishing to fill-up question- Results Demographic Characteristics of SubjectsThis paper describes diagnosis practices, and among of them 6 were foreigner specialist from UK, Australia, Africa, USA, Germany and China, who were working in that hospital since long years ago.The proportion of female number is nearly 50%; that was equal with the male experts. We could not find the diagnostic and management experiences difference between the male and female respondents. More than eighty percent doctors were full timer and the diagnosis process handling by them in the out-patient's department. Neither there was Geriatric ...

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General practitioners facing dementia: are they fully prepared?

Cited by 41 publications

References 0 publications

Practices in diagnosis, disclosure and pharmacotherapeutic management of dementia by general practitioners – a national survey

Practices in diagnosis, disclosure and pharmacotherapeutic management of dementia by general practitioners – a national survey

Primary care and dementia: 1. diagnosis, screening and disclosure

Multidisciplinary Doctor’s Clinical Practice, Confident And Difficulties To Manage And Care For Dementia In Remote Area Hospital

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