Systematic, early identification of dementia and dementia care management are highly appreciated by general physicians in primary care – results within a cluster-randomized-controlled trial (DelpHi)

Figures & data

Table 1 Sample description of general physicians (GPs) in residency in the federal state of Mecklenburg-Western Pomerania (MV) in Germany

Variables	DCM-GP, M (SD)/%		DelpHi-GP, M (SD)/%		GPs in MV M (SD)/%		Total sample, M (SD)/%
Age (years)	n=40	53.3 (7.4)	n=30	51.7 (7.8)	n=187	54.3 (8.0)	n=257	53.8 (7.9)
Sex (female)	n=21	52.5	n=17	58.6	n=102	55.7	n=140	55.6
In residency (years)	n=40	15.9 (8.2)	n=30	14.9 (9.4)	n=187	16.7 (7.5)	n=257	16.4 (7.9)
Type of practice
Single	n=29	72.5	n=20	66.7	n=129	69.4	n=178	69.5
Multiple GP	n=11	27.5	n=10	33.3	n=50	26.9	n=71	27.7
MVZ	n=0	0.0	n=0	0.0	n=7	3.8	n=7	2.7
Specific qualification
Geriatric	n=3	7.5	n=3	0.0	n=10	5.4	n=16	6.3
Dementia	n=0	0.0	n=1	3.4	n=7	3.8	n=8	3.2
Number of patients treated per quarter	n=40	1,158.5 (320.8)	n=30	1248.6 (471.4)	n=187	1,256.81 (506.9)	n=257	1,240.7 (478.6)
Number of PWD treated per quarter	n=40	56.7 (46.1)	n=30	66.7 (74.3)	n=187	59.7 (71.7)	n=257	60.0 (68.5)
Living at home	n=40	23.6 (23.3)	n=30	32.4 (62.8)	n=187	20.0 (24.0)	n=257	23.8 (34.6)
Living in nursing homes	n=40	19.3 (21.0)	n=30	25.1 (24.8)	n=187	22.5 (30.1)	n=257	20.4 (23.6)

Notes: DCM-GP, GPs participating in the intervention arm of the DelpHi study, having conducted systematic early detection and having experienced dementia care management; DelpHi-GP, GPs participating in the DelpHi study, having conducted systematic early detection; GP-MV, general physicians in Mecklenburg-Western Pomerania who did not participate in the DelpHi study. No statistically significant differences between groups.

Abbreviations: DCM, dementia care management; PWD, patient with dementia; SD, standard deviation; MVZ, medical care center.

Table 2 Statements toward early detection in primary care and agreement of general physicians (GPs) toward these statements

Statement	DCM-GP (n=40)	DelpHi-GP (n=30)	Total sample (n=70)
It was very helpful to implement a brief cognitive screening test like the DemTect to detect elderly patients with cognitive impairments M (SD)	4.5 (0.7)	4.3 (1.1)	4.4 (0.9)
Agreement %	95.0	82.7	89.9
Undecided %	2.5	6.9	4.3
Disagreement %	2.5	10.3	5.7
Conducting the DemTect was very feasible to implement in routine care M (SD)	4.0 (1.2)	3.8 (1.1)	3.9 (11)
Agreement %	62.5	58.6	60.8
Undecided %	25.0	24.1	24.6
Disagreement %	12.5	17.2	14.4
A systematic screening for all my elderly patients is useful M (SD)	4.0 (1.1)	3.6 (1.3)	3.8 (1.2)
Agreement %	70.0	55.2	63.7
Undecided %	20.0	24.1	23.2
Disagreement %	10.0	17.2	13.0
I will keep on using a brief screening test like the DemTect for the early identification of dementia in my practice M (SD)	4.5 (0.8)	4.1 (1.3)	4.3 (1.0)
Agreement %	85.0	72.4	79.7
Undecided %	12.5	13.8	13.0
Disagreement %	2.5	13.8	7.2
Did you identify patients as being cognitively impaired for the first time by using the DemTect? Yes %	62.5	56.7	60.0

Notes: DCM-GP, GPs participating in the intervention arm of the DelpHi study, having experienced dementia care management and having conducted systematic early detection; DelpHi-GP, GPs participating in the DelpHi study, having conducted systematic early detection. No statistically significant differences between groups.

Abbreviations: DCM, dementia care management; M, mean; SD, standard deviation.

Table 3 Statements toward dementia care management and agreement of general physicians (GPs) toward these statements

Statement	DCM-GP (n=40) M (SD)	Disagree (%)	Undecided (%)	Agree (%)
DCM has supported and relieved me in caring for PWD	3.9 (1.1)	12.1	21.2	66.6
Home visits were necessary to identify care gaps	3.8 (1.1)	12.1	33.3	54.5
Care situation of my patients has improved due to DCM	4.0 (0.9)	3.1	18.8	78.1
The systematically generated and provided GP-information letter was a good communication tool	4.1 (1.0)	9.4	12.5	78.1
Recommendations by the DCM regarding improvement of treatment and care were appropriate	4.1 (0.9)	9.7	9.7	80.6
Pharmaceutical recommendations given by pharmacists were helpful for the treatment of patients	3.3 (1.5)	32.2	14.3	53.6
Delegation of specific tasks to the DCM was helpful	3.7 (1.3)	20.7	17.2	62.0
I am satisfied with the care of my patients provided by DCM	4.3 (0.8)	3.4	6.9	89.7
I think my patients are satisfied with the care provided by DCM	4.3 (0.8)	3.6	10.7	85.8
Caregiver were relieved by the care provided by the DCM	3.9 (0.9)	6.9	24.1	68.9
Time spent on cooperating with the DCM was a useful investment	4.2 (0.7)	0.0	17.9	82.1
The professional competence of the DCM was high	4.4 (1.3)	0.0	7.4	92.5
DCM should be basic service in routine care	4.2 (1.3)	13.8	6.9	79.3
I would like to permanently cooperate with a DCM	4.1 (1.0)	10.3	10.3	79.3

Note: DCM-GP, GPs participating in the intervention arm of the DelpHi study, having experienced dementia care management and having conducted systematic early detection.

Abbreviations: PWD, patient with dementia; M, mean; SD, standard deviation; DCM, dementia care management.

Table 4 Attitudes toward dementia detection, treatment and care of general physicians (GPs) in Germany

Variables	DCM-GP (n=40) M (SD)	DelpHi-GP (n=30) M (SD)	GPs in MV (n=187) M (SD)	Total sample (n=257) M (SD)	Comparison sample* M (SD)
Attitude toward dementia detection and treatment	3.7 (0.7)	3.4 (0.9)	3.7 (0.7)	3.6 (0.7)	3.8 (0.7)
Confidence in own skills (personal)	3.4 (0.6)	3.1 (0.6)	3.4 (0.7)	3.4 (0.7)	3.4 (0.7)
Attitude toward
Dementia care in general	3.7 (0.7)	3.4 (0.7)	3.5 (0.7)	3.5 (0.7)	3.4 (0.7)
The detection process	3.8 (0.7)	3.3 (0.8)	3.7 (0.8)	3.7 (0.8)	3.4 (0.8)
Caregivers	3.8 (0.5)	3.6 (0.7)	3.7 (0.7)	3.7 (0.7)	3.6 (0.7)
Self-help	3.0 (0.9)	2.8 (1.1)	2.9 (1.1)	2.9 (1.1)	2.8 (1.2)
Guidelines and continued education	3.4 (0.9)	3.2 (0.9)	3.3 (0.9)	3.3 (0.9)	3.2 (1.0)
Confidence in own competence (knowledge)	3.4 (0.7)	3.1 (0.7)	3.3 (0.9)	3.3 (0.8)	3.1 (0.9)

Notes:

* Scores reanalyzed from the study of Thyrian and Hoffmann,⁴ sample of GPs in residency in MV in 2011; DCM-GP, GPs participating in the intervention arm of the DelpHi study, having conducted systematic early detection and having experienced dementia care management; DelpHi-GP, GPs participating in the DelpHi study, having conducted systematic early detection; GP-MV, general physicians in Mecklenburg-Western Pomerania, not participating in the DelpHi study.

Abbreviations: DCM, dementia care management; M, mean; SD, standard deviation.

ThyrianJRHoffmannWDementia care and general physicians-a survey on prevalence, means, attitudes and recommendationsCent Eur J Public Health201220427027523441391

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