Early detection of dementia: The knowledge and attitudes of primary care physicians in Hong Kong

Dementia Knowledge Among Primary Healthcare Physicians in Riyadh, Saudi Arabia

INTRODUCTION

Dementia poses a significant healthcare challenge globally, and healthcare providers must have adequate knowledge about its diagnosis, management, and support services. By assessing the knowledge level of primary care physicians in Riyadh, we can identify potential gaps and areas for improvement in dementia care, ultimately enhancing patient outcomes and quality of life. This study holds promise in shedding light on the current state of dementia knowledge among primary healthcare physicians in Riyadh and offering insights into strategies to enhance dementia care in this region.

METHODS

This cross-sectional questionnaire-based study was conducted from the first of June 2023 to the end of December 2023 in Riyadh, Saudi Arabia. A validated questionnaire was used to assess physicians' knowledge, attitude, and practice toward dementia.

RESULTS

A total of 151 physicians completed the questionnaires. The majority were male (55%), below 30 years of age (88.1%), and family medicine residents (84.8%). Most (74.8%) recognized old age as the most significant risk factor; an overwhelming majority of participants (98.7%) could not identify the minimum course of treatment to judge a medication's effectiveness. The average score of correct responses (7.74 ∓ 4.11) was equivalent to 38.7%. Furthermore, the average correct responses were significantly different among the different job levels of the participants.

CONCLUSIONS

The findings of this study highlight a lack of knowledge among primary care physicians regarding dementia, emphasizing the crucial importance of physician education in this area. Additionally, the results strongly indicate the need for emphasis on dementia education within the undergraduate medical curriculum, family medicine curriculum, and physician training programs. By addressing these educational gaps, we can better equip physicians to provide optimal care and support for individuals with dementia, ultimately improving patient care and quality of life.

Exploring barriers to dementia screening and management services by general practitioners in China: a qualitative study using the COM-B model

BACKGROUND

Dementia has become a global public health problem, and general practitioners (GPs) play a key role in diagnosing and managing dementia. However, in Chinese primary care settings, dementia is underdiagnosed and inefficiently managed, and dementia screening and management services provided by GPs are suboptimal. The reasons underlying this gap are poorly understood. This study aimed to determine the barriers that hinder GPs from actively promoting dementia screening and management, and thereby provide insights for the successful promotion of dementia screening and management services in primary care.

METHODS

Purposive sampling was used. And focus groups and in-depth interviews were conducted face-to-face among GPs from community health service centers (CHSCs) in South China. Thematic analysis was used to identify barriers to screening and managing dementia and map them to the Capability/Opportunity/Motivation-Behavior model (COM-B model).

RESULTS

Fifty-two GPs were included. The COM-B model found nine barriers to implementing dementia screening and management services in primary healthcare: (1) poor capability: lack of systematic knowledge of dementia and inadequate dementia screening skills; (2) little opportunity: unclear pathways for referral, insufficient time for dementia screening and management, lack of dementia-specific leaders, and no guarantee of services continuity; (3) low motivation: outside of GP scope, worries associated with dementia stigma rooted in culture beliefs, and insufficient financial incentives.

CONCLUSIONS

Our study concluded that GPs were not yet ready to provide dementia screening and management services due to poor capability related to knowledge and skills of dementia, little opportunity associated with an unsupportive working environment, and low motivation due to unclear duty and social pressure. Accordingly, systematic implementation strategies should be taken, including standardized dementia training programs, standardized community-based dementia guidelines, expansion of primary care workforces, development of dedicated leaders, and the eradication of stigma attached to dementia to promote dementia screening and management services in primary care.

Perceptions of Chinese Towards Dementia in Hong Kong-Diagnosis, Symptoms and Impacts

The increasing prevalence of dementia has become a public health issue worldwide including China. This study aims to explore the perception of Chinese in Hong Kong towards the diagnosis, symptoms and impacts of dementia. A cross-sectional survey was conducted among outpatients (without diagnosed dementia) attending a regional public hospital using a standard questionnaire. The results from 290 respondents showed that most preferred to be told about the diagnosis of dementia as soon as possible if they got it, in order to deal with the news and to access treatment and support early. Nearly two thirds of the respondents perceived practical issues (61.3%), physical health (61.0%), and emotional distress (58.4%) as their most fearful impacts, while legal issues (7.4%) were their least concerns. Family history/genes (79.1%) and brain injury (75.9%) were the most commonly perceived causes of dementia. For symptoms, respondents were more likely to identify cognitive impairments than undesirable behaviours. The accepting and proactive attitudes of the public indicate that there is a timely need of more public education about the disease, early screening and better continuity of care to fulfil the anticipated increase of the dementia patient population.