Rates of formal diagnosis of dementia in primary care: The effect of screening

Eichler, Tilly; Thyrian, Jochen René; Hertel, Johannes; Michalowsky, Bernhard; Wucherer, Diana; Dreier, Adina; Kilimann, Ingo; Teipel, Stefan J.; Hoffmann, Wolfgang

doi:10.1016/j.dadm.2014.11.007

Cited by 73 publications

(56 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The cognitive screening for identification of dementia can lead to both false negatives (e.g., in more highly educated patients) and false positives (e.g., in less educated patients). The rate of false-positive diagnoses in our study might have been lower than 24% [55]. That is, the results might have been distorted and should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 72%

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

Wucherer

Eichler

Hertel

et al. 2016

JAD

Self Cite

View full text Add to dashboard Cite

Background: Potentially inappropriate medication (PIM) in older people is a risk factor for adverse drug effects. This risk is even higher in older people with dementia (PWD).Objective: Our study aimed to determine (1) the prevalence of PIM among primary care patients who were screened positive for dementia and (2) the sociodemographic and clinical variables associated with the use of PIM.Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg–Western Pomerania) is a general practitioner-based, cluster-randomized, controlled intervention study to implement and evaluate an innovative concept of collaborative dementia care management in Germany. The comprehensive baseline assessment includes a home medication review. The present analyses are based on the data from 448 study participants (age 70+, DemTect <9). PIMs were identified using the list of Potentially Inappropriate Medications in the Elderly (Priscus).Results: (1) A total of 99 study participants (22%) received at least one PIM. The highest prevalence was found for antidepressants, benzodiazepines, and analgetics. The most frequently prescribed PIMs were amitriptyline, etoricoxib, and doxazosin. (2) Use of a PIM was significantly associated with a diagnosis of a mental or behavioral disorder.Conclusions: The prescription rate of PIMs for community-dwelling PWD was comparable with the rates found for the general population of older people in Germany (20–29%). Antidepressants with anticholinergic properties and long-acting benzodiazepines were the most prescribed PIMs, despite having an unfavorable benefit-risk ratio. This high prevalence of PIM prescriptions in a vulnerable population of PWD indicates that standard care for dementia should include careful medication review and management.

show abstract

Section: Discussionmentioning

confidence: 72%

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

Wucherer

Eichler

Hertel

et al. 2016

JAD

Self Cite

View full text Add to dashboard Cite

show abstract

“…Characteristics of the Survey/ Questionnaire studies reviewed or, year, et al, [39] et al, [45] To explore Table 7 Mixed Method studies et al, [24] d dom lementar ers ord et 014 [49] et al, [48] gh et al, [47] To adapt a US Table 8 Qualitative studies…”

Section: Strengths and Limitationsmentioning

confidence: 99%

What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

Gibson¹,

Goeman

Pond

2020

Preprint

View full text Add to dashboard Cite

Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged and Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published Australian and international literature to identify the existing and potential roles of Practice Nurse’s involvement in the delivery of care to people living with dementia or cognitive impairment and their support person(s) and also describe the characteristics and effectiveness of nurse interventions in dementia models of care in general practice. Methods: We systematically reviewed the evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search identified relevant original research published in English between January 2000 and January 2019 and available in full text. Thirteen articles were included. Results: Characteristics of roles, undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person were identified. These included increased patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions Further research is required to define and evaluate the scope of practice and characteristics of the Practice Nurse role in dementia care provision. Embedding in usual general practice care an evidence-based model of care describing the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic Review registration number PROSPERO 2018 CRD42018088191

show abstract

“…Vermutlich haben diese Zusammenhänge im Jahr 2013 zu einer deutlichen Zunahme von Demenz-Erstdiagnosen geführt. Die zusätzlich Finanzierung von testpsychologische Leistungen [4] und deren häufigere Durchführung [7] führte möglicherweise zu jenem Effekt, der in der DelpHi-MV Studie, bei dem einDemenz-Screening zu einer höheren Demenz-Diagnoserate geführt hat [26] , welche sich vor allem durch eine Erhöhung der "unspezifischen Demenzdiagnose" ergab. Originalarbeit Es bedarf weiterer Untersuchungen, ob diese Anreize den Motiven und Verfahrensweisen der HÄ entsprachen, zusätzlich bestimmte Leistungen zu erbringen und vermehrt Demenz-Diagnosen zu codieren.…”

Section: Inzidenzrate In Der Haus-und Facharztpraxisunclassified

Drastischer Anstieg neudiagnostizierter Patienten mit Demenz in deutschen Hausarztpraxen im Jahr 2013. Bessere Erkennung oder finanzieller Anreiz?

Bohlken

Michalowsky

Kostev

2017

Fortschr Neurol Psychiatr

Self Cite

View full text Add to dashboard Cite

(1) Is the increase also detectable in a subsample, (2) was there a comparable increase in specialist practices (SP), and (3) did the increase affect diagnostics and therapy? We analyzed billing data from 874 PCP and 141 SP (2011 to 2015) pertaining to more than 14,000 PwD/year with regard to the incidence of dementia diagnoses (ICD-10: G30, F01, F03) and antidementia prescriptions. The incidence abruptly increased by 47 % (2013) and 73 % (2014) compared to 2012. Proportions of nonspecific and vascular dementia diagnoses increased. Proportions of Alzheimer's and antidementia prescriptions decreased. No comparable developments were observed in SP. The drastic incidence increase in 2013 was closely linked to physician- and patient-related economic incentives. Whether a causal relationship existed and what consequences monetary incentives may have for PwD should be further investigated.

show abstract

Rates of formal diagnosis of dementia in primary care: The effect of screening

Cited by 73 publications

References 30 publications

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

Drastischer Anstieg neudiagnostizierter Patienten mit Demenz in deutschen Hausarztpraxen im Jahr 2013. Bessere Erkennung oder finanzieller Anreiz?

Contact Info

Product

Resources

About