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Most primary care clinics uncomfortable diagnosing dementia before referral

Focus group results showed that eight of nine primary care clinics felt uncomfortable diagnosing dementia before referral, according to study results presented at the 2016 American Geriatrics Society Annual Scientific Meeting.

Each focus group was led by researchers to help develop a telephone-based program, the Dementia Care Ecosystem (DCE), which complements primary care with dementia-focused care.

“Primary care lacks capacity to care for the growing number of older adults with dementia” Anna Chodos, MD, assistant professor of medicine at the University of California, San Francisco School of Medicine, and colleagues wrote. “One unique challenge is working with diverse primary care providers (PCPs) and practice types.”

To inform the DCE about how PCPs prefer to be engaged with their patients’ care, Chodos and colleagues conducted focus groups at nine primary care clinics: Five were public health clinics and four were university-affiliated clinics. Two of these were also geriatric clinics. For each focus group, the researchers asked questions about the collection of quality metrics, the challenges in dementia patient care and the preferred methods for patient referral and communication with the DCE group.

The researchers found that eight of nine sites felt uncomfortable diagnosing dementia before referral. The one clinic that felt comfortable was a university-based geriatric clinic. Each public clinic reported that they had limited access to specialty diagnostic care, and most PCPs reported difficulty with outpatient management of dementia due to a lack of resources. None of the clinics collected any dementia quality metrics data. In addition, all clinics felt positively about referring their patients to the DCE. Four clinics wanted to initiate the referral, while the other five clinics wanted to send only a list of prospective patients to the DCE.

“PCP focus group results take into account practice-specific needs and may improve co-management of adults with dementia in a novel dementia care program,” the researchers wrote. “Next steps will include analyzing dementia quality outcomes by clinic.” – by Will Offit

Reference:

Chodos AH, et al. Abstract C174. Presented at: 2016 American Geriatrics Society Annual Scientific Meeting; May 19-20; Long Beach, California.

Disclosure: The researchers report no relevant financial disclosures.