There has always been speculation that patients with dementia, a socially stigmatising disease, receive inferior treatment for their general health compared to patients without dementia. However, the few studies that have confronted this topic, using very different methodical and empirical approaches, have produced fairly inconsistent results. However, a recent systematic review on the quality of health care of physical illnesses in mentally ill patients, compared to those without mental illness, showed that most of the studies found inequity.1 These studies emanated predominantly from the US, as well from the UK, Finland, and the Netherlands2–9 and, for the most part, they were secondary evaluations of routine data. There is also a scarcity of studies surrounding other socially stigmatising diseases such as schizophrenia or depression. One of these studies uses an approach that is very similar to the one chosen in the current study.10 It was a matched-control study that focused on the preventive treatment of cardiovascular risk factors in individuals with a diagnosis of schizophrenia compared to the care of patients without this diagnosis. In this study,10 based in general practices in England, ‘negligence’ was found in the treatment of cardiovascular risk factors in patients with a diagnosis of schizophrenia.
How this fits in
There are only a few studies on patients with ‘stigmatised diseases’ such as dementia, schizophrenia, drug abuse, and depression, and the care of these patients concerning comorbidities or preventive measures. The results of these studies are conflicting. In this matched control study it was shown that German GPs do not seem to follow social stigmatisation when caring for hypertension, diabetes, and lipid disorders in patients with dementia.
Research question
This study aimed to find out whether patients who have been identified by their family doctor as having dementia are treated differently from patients who are classified as ‘non-demented’. Treatment parameters were chosen for hypertension, diabetes, and hyperlipidaemia, in order to gather measurable data on the quality of treatment.