Dementia prevention and the GP’s role: a qualitative interview study

Abstract

Background: General Practitioners (GPs) play an increasingly important role in proactively preventing dementia. 40% of dementia cases could be prevented or delayed by targeting 12 modifiable risk factors throughout life. However, little is known about how GPs perceive their role in dementia prevention and associated barriers. Aims:To explore the role of GPs in dementia prevention. Design and Setting: A qualitative study among UK GPs. Method: Semi-structured online interviews with 11 UK GPs exploring their views regarding their role in dementia prevention. Data were analysed using thematic analysis. Results: GPs reported that they never explicitly discuss dementia risk with patients, even when patients are presenting with risk factors, but acknowledge that dementia prevention should be part of their role. They advocate for adopting a whole team approach to primary care preventative practice, using long-term condition/medication reviews or NHS health checks as a platform to enable dementia risk communication targeting already at-risk individuals. Barriers included a lack of time, an absence of knowledge and education about the modifiable dementia risk factors, as well as a reluctance to use dementia as a term within the appointment for fear of causing health anxiety. Brain health was perceived as offering a more encouraging discursive tool for primary care practitioners, supporting communication and behaviour change. Conclusion: There need to be whole systems shift towards prioritising brain health and supporting primary care professionals in their preventative role. Education is key to underpinning this role in dementia prevention.

Multidomain Dementia Risk Reduction in Primary Care is Feasible: A Proof-of-concept study

“…They also agreed that it would be of added value to mention brain health in their role as health advisor. Indeed, findings from a qualitative study in general practitioners (GPs) from the United Kingdom also highlighted that GPs consider dementia risk reduction to fall within their scope [ 45 ]. Guidelines on how this can be done have been published [ 15 ].…”

“…Nonetheless, there are certain potential barriers that should be considered. Limited time and resources being the major ones, that may force PCPs to neglect efforts towards prevention, despite their intentions, as it is usually less of priority or urgent [ 45, 46 ]. Dutch general practitioners for example do not get reimbursed for dedicating time towards discussing prevention with their patients.…”

“…Dutch general practitioners for example do not get reimbursed for dedicating time towards discussing prevention with their patients. Additional education (e.g., educational meetings) for PCPs on the topic of dementia risk reduction is also recommended and is called for by PCPs themselves [ 45–48 ].…”

Re-thinking the role of primary care in dementia prevention

“…We read Jones and colleagues' paper on the role of GPs in dementia prevention with great interest. 1 While the research introduces a novel strategy for addressing this challenge and acknowledges barriers to communicating dementia risk such as time, there are some notable absences.…”

Dementia, like any condition, warrants conversations about risks and prevention

“…Surveys of healthcare professionals have found that they have a low awareness of dementia risk factors 3. And a recent—albeit small—qualitative study suggested that UK GPs don’t widely discuss dementia risk with their patients, even when their circumstances or lifestyles put them at increased risk 4. This includes having conditions like hypertension, which affects 16 million adults in the UK, many of whom successfully self-manage it 5…”