Description of general practitioners’ practices when suspecting cognitive impairment. Recourse to care in dementia (Recaredem) study

ABSTRACT

Objective: General practitioners (GPs) play a major role in the assessment of dementia but it is still unrecognized in primary care and its management is heterogeneous. Our objective is to describe the usual practices, and their determinants, of French GPs in this field.

Methods: GPs’ characteristics and practices when facing cognitive decline were collected through a telephone interview and a postal questionnaire.

A descriptive analysis of all study variables was conducted. The study of quantitative explanatory variables was done by testing the equality of means and the choice of qualitative variables was based on the chi-square independence test or Fischer test.

Results: Hundred two GPs completed the study. GPs were in majority men, working in urban areas. Mean age was 54.4 years old. GPs’ feeling of confidence and self-perception of follow-up of national recommendations is linked with their practices. Performing a clinical interview to assess cognitive impairment is linked with good communication skills. GPs feel less confident to give information about resources for dementia. The main reason alleged for underdiagnosis is the limited effectiveness of drug therapy.

Conclusions: This study underlines the importance of GPs’ feeling of confidence when managing cognitively impaired patients with dementia, and the need of increasing training in the field of dementia, which could improve the awareness of GPs about diagnosis and available resources.

KEYWORDS:

• Dementia and cognitive disorders
• primary care
• screening and diagnosis

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Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by a grant from the Fondation Plan Alzheimer (Grant Number 2012-0137). The PAQUID study was supported by ARMA (Bordeaux), Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Conseil Général de la Dordogne, Conseil Général de la Gironde, Conseil Régional d'Aquitaine, Fondation de France, France Alzheimer (Paris), GIS Longévité, Institut National de la Santé et de la Recherche Médicale, Mutuelle Générale de l'Education Nationale, Mutualité Sociale Agricole, Novartis Pharma (France), and SCOR Insurance (France). The Three-City study is conducted under a partnership agreement between the National Institute of Health and Medical Research (INSERM), the University Bordeaux 2 Victor Segalen, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The Three-City study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Conseils Régionaux d'Aquitaine et Bourgogne, Fondation de France, Ministry of Research-INSERM Programme ‘Cohortes et collections de données biologiques’, Agence Nationale de la Recherche [ANR-PNRA 2006, LongVie 2007], and the ‘Fondation Plan Alzheimer’ [FCS 2009–2012]. The AMI project was supported by AGRICA [CAMARCA, CRCCA, CCPMA PREVOYANCE, CPCEA, AGRI PREVOYANCE], the Mutualité Sociale Agricole (MSA) de Gironde, the Caisse Centrale de la Mutualité Sociale Agricole (CCMSA), and the CNSA (Caisse Nationale de Solidarité et d'Autonomie).