Dementia Care: Critical Interactions Among Primary Care Physicians, Patients and Caregivers

2005 ◽  
Vol 32 (3) ◽  
pp. 671-682 ◽  
Author(s):  
Sara B. Holmes ◽  
Dale Adler
2009 ◽  
Vol 21 (S1) ◽  
pp. S44-S52 ◽  
Author(s):  
Debra L. Cherry ◽  
Carol Hahn ◽  
Barbara G. Vickrey

ABSTRACTThis paper presents a strategy for training primary care physicians in the identification, diagnosis and management of Alzheimer's disease and related disorders. The strategy uses evidence-based practice guidelines to establish quality benchmarks and then provides training and other interventions to improve the quality of care received by these patients. The three projects described in this paper assumed that training of primary care physicians alone would not be sufficient to achieve the quality benchmarks derived from guidelines. The projects used creative training strategies supplemented by provider “tool kits”, provider checklists, educational detailing, and endorsement from organizational leadership to reinforce what the primary care providers learned in educational sessions. Each project also implemented a system of dementia care management to “wrap around” traditional primary care to ensure that quality benchmarks would be achieved. Outcomes of two completed studies support the premise that it is possible to improve quality of dementia care through physician education that occurs in association with a coordinated system of dementia care management and in collaboration with community agencies to access guideline-recommended social services.


2007 ◽  
Vol 22 (11) ◽  
pp. 1487-1492 ◽  
Author(s):  
Ladson Hinton ◽  
Carol E. Franz ◽  
Geetha Reddy ◽  
Yvette Flores ◽  
Richard L. Kravitz ◽  
...  

2018 ◽  
Vol 59 (6) ◽  
pp. e697-e708 ◽  
Author(s):  
Elise Mansfield ◽  
Natasha Noble ◽  
Rob Sanson-Fisher ◽  
Danielle Mazza ◽  
Jamie Bryant

Abstract Background and Objectives Primary care physicians (PCPs) have a key role in providing care for people with dementia and their carers, however, a range of barriers prevent them from delivering optimal care. We reviewed studies on PCPs’ perceptions of barriers to providing optimal dementia care, including their methodological quality, whether they focused on barriers related to diagnosis and/or management, and the patient-, provider-, and system-level barriers identified. Research Design and Methods Studies were included if they were quantitative studies published since 2006 which reported on PCPs’ perceptions of the barriers to providing dementia care. The methodological quality of identified studies was assessed using an adapted version of accepted rating criteria for quantitative studies. Data were extracted from studies which were rated as “moderate” or “strong” quality. Results A total of 20 studies were identified, 16 of which were rated as “moderate” or “strong” methodological quality. Patient-related barriers included a reluctance to acknowledge cognitive decline and patient nonadherence to management plans. Provider-related barriers included a lack of training and confidence. System-related barriers included a lack of time during consultations and lack of support services. Discussion and Implications This review highlights a range of barriers to dementia diagnosis and management from studies rated as being methodologically adequate. Future studies should also utilize theory-driven approaches to exploring a comprehensive range of barriers to optimal dementia care across the care trajectory.


Dementia ◽  
2002 ◽  
Vol 1 (2) ◽  
pp. 227-240 ◽  
Author(s):  
Richard H. Fortinsky ◽  
Christine G. Unson ◽  
Ramon I. Garcia

2009 ◽  
Vol 50 (2) ◽  
pp. 179-191 ◽  
Author(s):  
R. H. Fortinsky ◽  
I. Zlateva ◽  
C. Delaney ◽  
A. Kleppinger

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.


2007 ◽  
Vol 177 (4S) ◽  
pp. 517-517
Author(s):  
John M. Hollingsworth ◽  
Stephanie Daignault ◽  
Brent K. Hollenbeck ◽  
John T. Wei

Sign in / Sign up

Export Citation Format

Share Document