Safety and effectiveness of dementia care management in primary care
Keywords:Dementia, Primary, Care, Management, Support
Globally, dementia affects 47.5 million people, making it a significant health concern. The growing number of people with dementia is posing a challenge to the health care systems. Dementia is a complicated progressive syndrome which is characterized by impairment of cognition, changes in personality leading to impeded daily life activities. Dementia poses burden to patients, their families society and healthcare systems in context of cost and care. People with dementia need intense medical, nursing, psychological, and social support to slow the disease's progression and retain autonomy and social inclusion. Primary care has been shown to be the first point of contact for patients with dementia (PWD), making it an appropriate setting for diagnosis, in-depth needs assessments, and the beginning of dementia-specific therapy and care. The majority of dementia patients are treated in primary care settings and deal with complex medical and psychological conditions. They also suffer from various comorbid diseases along with dementia and take numerous psychotropic medications, including anticholinergics. However, the primary care system frequently fails to recognize their dementia-related symptoms due to certain constraints including time and lack of resources. Hence, the primary care system has to be supported with a variety of resources, such as dementia care managers, access to and coordination with interdisciplinary dementia specialists, and a practical dementia screening and diagnostic procedure, in order to provide better care for these vulnerable patients. The purpose of this research is to review the available information about safety and effectiveness of dementia care management in primary care.
Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and Management of Dementia: Review. JAMA. 2019;322(16):1589-9.
Thyrian JR, Hertel J, Wucherer D. Effectiveness and Safety of Dementia Care Management in Primary Care: A Randomized Clinical Trial. JAMA Psychiatr. 2017;74(10):996-1004.
Sodri NI, Mohamed-Yassin MS, Mohamad M, Baharudin N. Confidence in Dementia Management and Its Associated Factors among Primary Care Doctors in Malaysia. Int J Environ Res Public Health. 2022;19(16).
Gibson C, Goeman D, Hutchinson A, Yates M, Pond D. The provision of dementia care in general practice: practice nurse perceptions of their role. BMC Fam Pract. 2021;22(1):110.
Poon NY, Ooi CH, How CH, Yoon PS. Dementia management: a brief overview for primary care clinicians. Singapore Med Jl. 2018;59(6):295-9.
Jennings LA, Tan Z, Wenger NS. Quality of Care Provided by a Comprehensive Dementia Care Comanagement Program. J Am Geriatr Society. 2016;64(8):1724-30.
Boustani M, Schubert C, Sennour Y. The challenge of supporting care for dementia in primary care. Clin Interventions Aging. 2007;2(4):631-6.
Frost R, Walters K, Aw S. Effectiveness of different post-diagnostic dementia care models delivered by primary care: a systematic review. Bri J General Pract. 2020;70(695):e434-41.
Parmar J, Dobbs B, McKay R. Diagnosis and management of dementia in primary care: exploratory study. Can Fam Physician. 2014;60(5):457-65.
Fox C, Maidment I, Moniz-Cook E. Optimising primary care for people with dementia. Mental Heal Fam Med. 2013;10(3):143-51.
Khanassov V, Rojas-Rozo L, Sourial R, Yang XQ, Vedel I. Needs of patients with dementia and their caregivers in primary care: lessons learned from the Alzheimer plan of Quebec. BMC Fam Pract. 2021;22(1):186.
Dreier-Wolfgramm A, Michalowsky B, Austrom MG. Dementia care management in primary care : Current collaborative care models and the case for interprofessional education. Zeitschrift fur Gerontologie und Geriatrie. 2017;50(2):68-77.
Burns R, Nichols LO, Martindale-Adams J, Graney MJ, Lummus A. Primary care interventions for dementia caregivers: 2-year outcomes from the REACH study. Gerontologist. 2003;43(4):547-55.
Lathren CR, Sloane PD, Hoyle JD, Zimmerman S, Kaufer DI. 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. BMC Geriatr. 2013;13:134.
Bablok I, Binder H, Stelzer D. Primary dementia care based on the individual needs of the patient: study protocol of the cluster randomized controlled trial, DemStepCare. BMC Geriatr. 2021;21(1):222.
Petrazzuoli F, Vinker S, Koskela TH. Exploring dementia management attitudes in primary care: a key informant survey to primary care physicians in 25 European countries. Int Psychogeriatr. 2017;29(9):1413-23.
Fernandez HH, Boyd JT, Fung VSC. Long-term safety and efficacy of levodopa-carbidopa intestinal gel in advanced Parkinson's disease. Movement Disorders. 2018;33(6):928-36.