RT Journal Article
SR Electronic
T1 Quality of care provided to people with dementia: utilisation and quality of the annual dementia review in general practice
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e91
OP e98
DO 10.3399/bjgp12X625148
VO 62
IS 595
A1 Amanda Connolly
A1 Steve Iliffe
A1 Ella Gaehl
A1 Stephen Campbell
A1 Richard Drake
A1 Julie Morris
A1 Helen Martin
A1 Nitin Purandare
YR 2012
UL http://bjgp.org/content/62/595/e91.abstract
AB Background Primary care services are often the main healthcare service for people with dementia; as such, good-quality care at this level is important.Aim To measure the quality of care provided to people with dementia in general practice using routinely collected data, and to explore associated patient and practice factors.Design and setting Observational, cross-sectional review of medical records from general practices (n = 52) in five primary care trusts.Method A total of 994 people with dementia were identified from dementia registers. An unweighted quality-of-care score was constructed using information collected in the annual dementia review, together with pharmacological management of cognitive and non-cognitive symptoms. Multilevel modelling was carried out to identify factors associated with quality-of-care scores.Results In total, 599 out of 745 (80%) patients with dementia had received an annual dementia review; however, a social care review or discussion with carers was evident in just 305 (51%) and 367 (61%) of those 599 cases, respectively. Despite high prevalence of vascular disease, over a quarter (n = 259, 26%) of all patients with dementia were prescribed antipsychotics; only 57% (n = 148) of these had undergone medication review in the previous 6 months. Those with vascular dementia who were registered with single-handed practices received poorer quality of care than those registered with practices that had more than one GP.Conclusion Although the number of people with dementia with a record of an annual dementia review is high, the quality of these reviews is suboptimal. The quality score developed in this study could be used as one source of data to identify weaknesses in practice activity that need to be corrected, and so would be of value to commissioners and regulators, as well as practices themselves.