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Early diagnosis and management of dementia in general practice - how do Swiss GPs meet the challenge?

Giezendanner, Stephanie and Monsch, Andreas U. and Kressig, Reto W. and Mueller, Yolanda and Streit, Sven and Essig, Stefan and Zeller, Andreas and Bally, Klaus. (2018) Early diagnosis and management of dementia in general practice - how do Swiss GPs meet the challenge? Swiss Medical Weekly, 148. w14695.

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Official URL: https://edoc.unibas.ch/79893/

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Abstract

In general practice, the diagnosis of dementia is often delayed. Therefore, the Swiss National Dementia Strategy 2014 concluded that action was needed to improve patient care. Little is known about GPs' confidence in and approach to the diagnosis, disclosure and post-diagnostic management of individuals with dementia in Switzerland. The aim of this survey is to assess these elements of dementia care and GPs' views on the adequacy of health care services regarding dementia.; Cross-sectional postal survey in Switzerland in 2017 supported by all academic institutes of general practice in Swiss universities. Members of the Swiss Association of General Practitioners (n = 4460) were asked to participate in the survey. In addition to the GPs' demographic characteristics, the survey addressed the following issues: GPs' views on the adequacy of health care services, clinical approach and confidence in the management of dementia.; The survey response rate was 21%. The majority of GPs (64%) felt confident diagnosing dementia, but not in patients with a migration background (15%). For neuropsychological testing, three-quarters of GPs collaborated with memory clinics and were satisfied with the access to diagnostic services. At the time of first diagnosis, 62% of GPs diagnosed the majority of their patients with a mild stage of dementia, and 31% with a mild cognitive impairment. The most frequent actions taken by GPs after the diagnosis of mild dementia were giving advice to relatives (71%), testing fitness-to-drive (66%) and minimising cardiovascular risk factors (63%). While 65% of GPs felt confident taking care of patients with dementia, fewer (53%) felt confident in pharmacological treatment, coping with suicidal ideation (44%) or caring for patients with a migration background (16%). Half of GPs preferred to delegate the assessment of fitness-to-drive to an official authority. One in four GPs was not satisfied with the local provision of care and support facilities for patients with dementia.; Overall, GPs reported confidence in establishing a diagnosis of dementia and sufficient access to diagnostic services. Post-diagnostic management primarily focused on counselling and harm reduction rather than pharmacological treatment. Future educational support for GPs should be developed, concentrating on coping with their patients' suicidal ideation and caring for patients with a migration background. What do you want to do ? New mail Copy
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Geriatrie > Geriatrie (Kressig)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Geriatrie > Geriatrie (Kressig)
07 Faculty of Psychology > Departement Psychologie
07 Faculty of Psychology > Departement Psychologie > Forschungsbereich Klinische Psychologie und Neurowissenschaften > Molecular Psychology (Papassotiropoulos)
UniBasel Contributors:Monsch, Andreas U. U
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:EMH Schweizerischer Arzteverlag
ISSN:1424-7860
e-ISSN:1424-3997
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:22 Dec 2020 08:15
Deposited On:22 Dec 2020 08:15

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