Practices in diagnosis, disclosure and pharmacotherapeutic management of dementia by general practitioners – a national survey

Abstract

Objectives: To explore the practice patterns of general practitioners (GPs) for the diagnosis, disclosure and pharmacological management of individuals with dementia. We also investigated whether the number of years working in general practice is a determinant factor associated with the responses obtained.

Method: A national survey was sent to all registered GPs in the Maltese islands. The return rate was 54.2% with the majority of respondents having 15 years or more working experience in general practice. Chi-square analysis of variance was used to determine any relationship effects.

Results: Although the majority of GPs indicated lack of competence in diagnosing dementia, only a small percentage showed a preference towards specialist referral. Lack of training was mostly envisaged by physicians with the least number of years in general practice. Significant differences in pharmacotherapeutic prescribing were noted depending on the stage of disease progression and the number of years working as a GP. Disease disclosure was not routinely carried out even though GPs were aware of the fact that disclosure may help individuals with dementia and their caregivers or relatives with future planning.

Conclusion: The findings show notable shortcomings in various aspects of dementia management by GPs. This highlights the need of providing continued educational support and training opportunities to enhance not only GPs’ clinical competence, but also their role as key players in providing quality support to individuals with dementia in the primary care setting.

Keywords:

• dementia
• Alzheimer's disease
• general practitioners
• training
• Malta

Acknowledgements

The authors would like to thank the physicians who participated in the study, the Malta College of Family Doctors and the editor of ‘The Synapse Magazine’.