Quality of care provided to people with dementia: Utilisation and quality of the annual dementia review in general practice

Amanda Connolly, Steve Iliffe, Ella Gaehl, Stephen Campbell, Richard Drake, Julie Morris, Helen Martin, Nitin Purandare

    Research output: Contribution to journalArticlepeer-review

    Abstract

    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 ofmedical records fromgeneral practices (n = 52) in five primary care trusts. Method: A total of 994 people with dementia were identified fromdementia 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 undergonemedication review in the previous 6months. Those with vascular dementia who were registered with single-handed practices received poorer quality of care than those registered with practices that hadmore 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. ©British Journal of General Practice.
    Original languageEnglish
    Pages (from-to)e91-e98
    JournalBritish Journal of General Practice
    Volume62
    Issue number595
    DOIs
    Publication statusPublished - Feb 2012

    Keywords

    • Dementia
    • General practice
    • Health care
    • Quality indicators

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