Improving dementia diagnosis and management in primary care: a cohort study of the impact of a training and support program on physician competency, practice patterns, and community linkages

• Published in: BMC geriatrics Vol. 13; no. 1; pp. 134 - 7 pages
• Main Authors: Lathren, Christine R, Sloane, Philip D, Hoyle, Joseph D, Zimmerman, Sheryl, Kaufer, Daniel I
• Format: Journal Article
• Language: English
• Published: London BioMed Central 10.12.2013; BioMed Central Ltd
• Subjects: Adult; Aging; Care and treatment; Caregivers; Clinical Competence - standards; Cohort Studies; Consultants; Dementia; Dementia - diagnosis; Dementia - epidemiology; Dementia - therapy; Diagnosis; Disease Management; Education; Evidence-based medicine; Female; Geriatrics; Geriatrics/Gerontology; Health aspects; Health services; Health services research; Humans; Male; Medical referrals; Medicine; Medicine & Public Health; Middle Aged; Patient education; Physician's Role; Physicians; Pilot Projects; Primary care; Primary Health Care - methods; Primary Health Care - standards; Questionnaires; Rehabilitation; Research Article; Residence Characteristics; Social aspects; United States; North Carolina; United States > US; Community Resource; Primary Care Office; Dementia Care; Dementia; Primary Care Physician
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/1471-2318-13-134

Background Primary care physicians routinely provide dementia care, but may lack the clinical skills and awareness of available resources to provide optimal care. We conducted a community-based pilot dementia training intervention designed to both improve clinical competency and increase utilization of local dementia care services. Methods Physicians (N = 29) and affiliated staff (N = 24) participated in a one-day training program on dementia screening, diagnosis and management that included direct engagement with local support service providers. Questionnaires about their dementia care competency and referral patterns were completed before and 6 months after the training intervention. Results Physicians reported significantly higher overall confidence in their dementia care competency 6 months post-training compared to pre-training. The largest reported improvements were in their ability to educate patients and caregivers about dementia and making appropriate referrals to community care services. Participants also reported markedly increased use of cognitive screening tools in providing care. Community service providers recorded approximately 160 physician-initiated referrals over a 2 year-period post-training, compared to few beforehand. Conclusions Combining a targeted physician practice-based educational intervention with community service engagement improves dementia care competency in clinicians and promotes linkages between clinical and community dementia care providers.