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Hegerath FM, Giehl C, Pentzek M, Vollmar HC, Otte IC. Transition of patients with recently diagnosed Dementia from inpatient to outpatient setting- a scoping review. BMC Geriatr 2024; 24:37. [PMID: 38191313 PMCID: PMC10775549 DOI: 10.1186/s12877-023-04638-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/25/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION After being diagnosed with dementia, patients need a medical professional to empathetically address their fears and get initial questions answered. This scoping review therefore addresses how patients newly diagnosed with dementia are cared for in the general practitioner (GP) setting and how the communication between different healthcare professionals and the GP is handled. METHODS The scoping review was conducted based on the PRISMA Extension for Scoping Reviews checklist. After developing a search algorithm, literature searches were performed in PubMed, Scopus, Web of Science, Cochrane Library, PsychInfo, GeroLit and Cinahl using defined search criteria, such as a focus on qualitative study designs. After the removal of duplicates, title/abstract and full text screening was carried out. RESULTS Final data extraction included 10 articles out of 12,633 records. Strategies regarding the post-acute care of newly diagnosed patients included providing clarity and comfort to the patients and giving support and information both pre- and post-diagnosis. Care efforts were focused on advanced care planning and deprescribing. Involving people with dementia and their caregivers in further care was seen as crucial to provide them with the support needed. GPs emphasised the importance of listening to concerns, as well as ensuring wishes are respected, and autonomy is maintained. All studies found communication between the GP setting and other healthcare professionals regarding post-acute care to be inadequate. Lack of information sharing, clinical notes and recommendations for the GP setting resulted in inefficient provision of support, as GPs feel limited in their ability to act. DISCUSSION Sharing necessary information with the GP setting could promote patient-centred care for people living with dementia and facilitate appropriate and timely resource allocation and effective healthcare collaboration between the settings, for example, by defining clear care pathways and clarifying roles and expectations.
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Affiliation(s)
- Flora-Marie Hegerath
- Institute of General Practice and Family Medicine (AM RUB), Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany.
| | - Chantal Giehl
- Institute of General Practice and Family Medicine (AM RUB), Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
| | - Michael Pentzek
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, 45147, Essen, Germany
| | - Horst Christian Vollmar
- Institute of General Practice and Family Medicine (AM RUB), Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
| | - Ina Carola Otte
- Institute of General Practice and Family Medicine (AM RUB), Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
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Lech S, O'Sullivan JL, Drewelies J, Herrmann W, Spang RP, Voigt-Antons JN, Nordheim J, Gellert P. Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study. BMC Geriatr 2021; 21:717. [PMID: 34922486 PMCID: PMC8683809 DOI: 10.1186/s12877-021-02650-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices. Methods A cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life. Results Self-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25–100). Adherence to specific recommendations varied widely (from 19.2 to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = − 5.58, CI = − 10.97, − 0.19, p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = −.86, CI = − 4.18, 2.47, p = .61). Conclusion The present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care. Trial registration The DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02650-8.
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Affiliation(s)
- Sonia Lech
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany. .,Brandenburg Medical School Theodor Fontane, Department of Psychiatry, Psychotherapy and Psychosomatics, Neuruppin, Germany.
| | - Julie L O'Sullivan
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Johanna Drewelies
- Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany
| | - Wolfram Herrmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of General Practice, Berlin, Germany
| | - Robert P Spang
- Technische Universität Berlin, Quality and Usability Lab, Berlin, Germany
| | - Jan-Niklas Voigt-Antons
- Technische Universität Berlin, Quality and Usability Lab, Berlin, Germany.,Deutsches Forschungszentrum für Künstliche Intelligenz GmbH (DFKI), Speech and Language Technology, Berlin, Germany
| | - Johanna Nordheim
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Paul Gellert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany
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