Practice Patterns, Beliefs, and Perceived Barriers to Care Regarding Dementia: A Report from the American Academy of Family Physicians (AAFP) National Research Network
| Autor: | Wilson D. Pace, Letoynia Coombs, Natalia Loskutova, James M. Galliher, Thomas V. Stewart, Elizabeth W. Staton, Jessica Huff, Gregg A. Warshaw |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Attitude of Health Personnel media_common.quotation_subject Population Urinary incontinence Anger Surveys and Questionnaires mental disorders medicine Humans Dementia Practice Patterns Physicians' Paranoia education Psychiatry Referral and Consultation Aged media_common Aged 80 and over Response rate (survey) education.field_of_study Practice patterns business.industry Public Health Environmental and Occupational Health Middle Aged medicine.disease United States Logistic Models Health Care Surveys Family medicine Multivariate Analysis Delirium Female medicine.symptom Family Practice business |
| Zdroj: | The Journal of the American Board of Family Medicine. 27:275-283 |
| ISSN: | 1558-7118 1557-2625 |
| DOI: | 10.3122/jabfm.2014.02.120284 |
| Popis: | Purpose: Given the increasing age of the US population, understanding how primary care is delivered surrounding dementia and physicians9 perceived barriers and needs associated with this care is essential. Methods: A 29-item questionnaire was developed by project investigators and family physician consultants and mailed to a random sample of 1500 US members of the American Academy of Family Physicians in 2008; 2 follow-up mailings were sent to nonrespondents. Physicians were queried about sociodemographic characteristics, practice patterns, and beliefs (including challenges, barriers, and needs) about care processes focusing on dementia among older patients. Results: The response rate was 60%, with respondents statistically comparable (P > .05) to the American Academy of Family Physicians physician population. Among physicians, 93% screen and/or conduct diagnostic evaluations for dementia in older patients, whereas 91% provide ongoing primary care for patients with dementia whether or not they screen for or diagnose dementia. Forty percent of physicians refer some patients with suspected dementia to other providers (primarily neurologists) to verify diagnosis, for comanagement, or both. Factors affecting the diagnosis of dementia and the delivery of dementia care included patient behavior challenges (aggressiveness, restlessness, paranoia, wandering); comorbidities (falls, delirium, adverse medication reactions, urinary incontinence); caregiver challenges (fatigue, planning for patient9s institutional placement, anger); and structural barriers (clinician time, time required for screening, limited treatment options). Tools needed to provide enhanced dementia care included better assessment tools, community resources, and diagnostic and screening tools. Conclusion: Family physicians are highly involved in the assessment and routine care of patients with suspected dementia or diagnosed with dementia, although a relative few are not. This is despite the recognized challenges physicians encounter in the assessment and care processes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|