S Cahill1, M Clark, H O'Connell, B Lawlor, R F Coen, C Walsh. 1. Dementia Services Information and Development Centre, St James's Hospital, Dublin Ireland, Trinity College Dublin, Ireland. dsidc@stjames.ie
Abstract
BACKGROUND: The diagnosis of dementia poses difficulties for general practitioners (GPs) particularly when access to specialist diagnostic services is delayed. Ireland is soon to witness an increase in numbers of people presenting with dementia, yet little is known about the service needs of GPs when attempting to diagnose dementia. OBJECTIVES: To detail the service needs of GPs, especially their training needs, access to diagnostic resources such as CT and MRI brain scans and access to specialist services such as Old Age Psychiatry (OAP), Geriatric Medicine (GM) and Neuropsychology (NP). METHODS: The paper is based on survey data collected from a sample of GPs (n = 300) registered with the Irish College of General Practitioners (ICGP) and on qualitative data collected from a Focus Group (n = 7). RESULTS: GPs were more likely to blame themselves than either the health care system, their patients or family members for the late presentation of dementia in primary care. Stigma was a major obstacle preventing GPs from being more proactive in this area. Rural GPs felt geographically disadvantaged accessing diagnostic services and both rural and urban GPs experienced considerable time delays accessing specialist diagnostic services. CONCLUSIONS: Findings provide compelling evidence that training and access to diagnostic services are only two of several different structural and ideological obstacles that GPs encounter when attempting to diagnose dementia. Future educational supports for GPs need to be developed which concentrate on these areas.
BACKGROUND: The diagnosis of dementia poses difficulties for general practitioners (GPs) particularly when access to specialist diagnostic services is delayed. Ireland is soon to witness an increase in numbers of people presenting with dementia, yet little is known about the service needs of GPs when attempting to diagnose dementia. OBJECTIVES: To detail the service needs of GPs, especially their training needs, access to diagnostic resources such as CT and MRI brain scans and access to specialist services such as Old Age Psychiatry (OAP), Geriatric Medicine (GM) and Neuropsychology (NP). METHODS: The paper is based on survey data collected from a sample of GPs (n = 300) registered with the Irish College of General Practitioners (ICGP) and on qualitative data collected from a Focus Group (n = 7). RESULTS: GPs were more likely to blame themselves than either the health care system, their patients or family members for the late presentation of dementia in primary care. Stigma was a major obstacle preventing GPs from being more proactive in this area. Rural GPs felt geographically disadvantaged accessing diagnostic services and both rural and urban GPs experienced considerable time delays accessing specialist diagnostic services. CONCLUSIONS: Findings provide compelling evidence that training and access to diagnostic services are only two of several different structural and ideological obstacles that GPs encounter when attempting to diagnose dementia. Future educational supports for GPs need to be developed which concentrate on these areas.
Authors: H Villars; S Oustric; S Andrieu; J P Baeyens; R Bernabei; H Brodaty; K Brummel-Smith; C Celafu; N Chappell; J Fitten; G Frisoni; L Froelich; O Guerin; G Gold; I Holmerova; S Iliffe; A Lukas; R Melis; J E Morley; H Nies; F Nourhashemi; J Petermans; J Ribera Casado; L Rubenstein; A Salva; C Sieber; A Sinclair; R Schindler; E Stephan; R Y Wong; B Vellas Journal: J Nutr Health Aging Date: 2010-02 Impact factor: 4.075
Authors: Rolf Holle; Elmar Grässel; Stefan Ruckdäschel; Sonja Wunder; Hilmar Mehlig; Peter Marx; Olaf Pirk; Martin Butzlaff; Simone Kunz; Jörg Lauterberg Journal: BMC Health Serv Res Date: 2009-06-06 Impact factor: 2.655