Primary Care Physicians' Perceived Barriers to Optimal Dementia Care: A Systematic Review.
Alzheimer’s disease
Analysis—systematic review
Primary care
Quality of care
Journal
The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327
Informations de publication
Date de publication:
16 11 2019
16 11 2019
Historique:
received:
10
10
2017
pubmed:
26
6
2018
medline:
24
4
2020
entrez:
26
6
2018
Statut:
ppublish
Résumé
Primary care physicians (PCPs) have a key role in providing care for people with dementia and their carers, however, a range of barriers prevent them from delivering optimal care. We reviewed studies on PCPs' perceptions of barriers to providing optimal dementia care, including their methodological quality, whether they focused on barriers related to diagnosis and/or management, and the patient-, provider-, and system-level barriers identified. Studies were included if they were quantitative studies published since 2006 which reported on PCPs' perceptions of the barriers to providing dementia care. The methodological quality of identified studies was assessed using an adapted version of accepted rating criteria for quantitative studies. Data were extracted from studies which were rated as "moderate" or "strong" quality. A total of 20 studies were identified, 16 of which were rated as "moderate" or "strong" methodological quality. Patient-related barriers included a reluctance to acknowledge cognitive decline and patient nonadherence to management plans. Provider-related barriers included a lack of training and confidence. System-related barriers included a lack of time during consultations and lack of support services. This review highlights a range of barriers to dementia diagnosis and management from studies rated as being methodologically adequate. Future studies should also utilize theory-driven approaches to exploring a comprehensive range of barriers to optimal dementia care across the care trajectory.
Sections du résumé
BACKGROUND AND OBJECTIVES
Primary care physicians (PCPs) have a key role in providing care for people with dementia and their carers, however, a range of barriers prevent them from delivering optimal care. We reviewed studies on PCPs' perceptions of barriers to providing optimal dementia care, including their methodological quality, whether they focused on barriers related to diagnosis and/or management, and the patient-, provider-, and system-level barriers identified.
RESEARCH DESIGN AND METHODS
Studies were included if they were quantitative studies published since 2006 which reported on PCPs' perceptions of the barriers to providing dementia care. The methodological quality of identified studies was assessed using an adapted version of accepted rating criteria for quantitative studies. Data were extracted from studies which were rated as "moderate" or "strong" quality.
RESULTS
A total of 20 studies were identified, 16 of which were rated as "moderate" or "strong" methodological quality. Patient-related barriers included a reluctance to acknowledge cognitive decline and patient nonadherence to management plans. Provider-related barriers included a lack of training and confidence. System-related barriers included a lack of time during consultations and lack of support services.
DISCUSSION AND IMPLICATIONS
This review highlights a range of barriers to dementia diagnosis and management from studies rated as being methodologically adequate. Future studies should also utilize theory-driven approaches to exploring a comprehensive range of barriers to optimal dementia care across the care trajectory.
Identifiants
pubmed: 29939234
pii: 5043527
doi: 10.1093/geront/gny067
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e697-e708Informations de copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.