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Donath, C.* ; Gräßel, E.* ; Grossfeld-Schmitz, M.* ; Menn, P. ; Lauterberg, J.* ; Wunder, S.* ; Marx, P.* ; Ruckdäschel, S.* ; Mehlig, H.* ; Holle, R.

Effects of general practitioner training and family support services on the care of home-dwelling dementia patients - results of a controlled cluster-randomized study.

BMC Health Serv. Res. 10:314 (2010)
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BACKGROUND: More than 90% of dementia patients are cared for by their general practitioners, who are decisively involved in the diagnosis, therapy and recommendation of support services. Objective: To test whether special training of general practitioners alters the care of dementia patients through their systematic recommendation of caregiver counseling and support groups. METHOD: 129 general practitioners enrolled 390 dementia patients and their informal caregivers in a prospective, three-arm cluster-randomized 2-year study. Arm A constituted usual care, in Arm B and C support groups and caregiver counseling (in Arm B one year after baseline, in Arm C at baseline) were recommended by the general practitioners. The general practitioners received arm-specific training. Diagnostic and therapeutic behavior of physicians was recorded at baseline. Informal caregivers were questioned in follow-up after 2 years about the utilization of support services. RESULTS: The diagnostic behavior of the general practitioners conforms to relevant guidelines. The procedure in newly-diagnosed patients does not differ from previously diagnosed patients with the exception of the rate of referral to a specialist. About one-third of the newly-diagnosed dementia patients are given an anti-dementia drug. The utilization of support groups and counseling increased five- and fourfold, respectively. Utilization of other support services remained low (< 10%), with the exception of home nursing and institutional short-term nursing. CONCLUSION: Trained general practitioners usually act in conformity with guidelines with respect to diagnosing dementia, and partly in conformity with the guidelines with respect to recommended drug therapy. Recommendations of support services for informal caregivers by the general practitioner are successful. They result in a marked increase in the utilization rate for the recommended services compared to offers which are not recommended by the general practitioner.
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Publication type Article: Journal article
Document type Scientific Article
Keywords POINT-OF-VIEW; EXPECTED QUALITY; EARLY-DIAGNOSIS; ALZHEIMERS-DISEASE; CAREGIVERS; PREDICTORS; PHYSICIANS; ATTITUDES; PEOPLE; HEALTH
Language english
Publication Year 2010
HGF-reported in Year 2010
ISSN (print) / ISBN 1472-6963
e-ISSN 1472-6963
Journal BMC Health Services Research
Quellenangaben Volume: 10, Issue: , Pages: , Article Number: 314 Supplement: ,
Publisher BioMed Central
Reviewing status Peer reviewed
Institute(s) Institute of Health Economics and Health Care Management (IGM)
POF-Topic(s) 30202 - Environmental Health
Research field(s) Genetics and Epidemiology
PSP Element(s) G-505300-002
PubMed ID 21087474
DOI 10.1186/1472-6963-10-314
WOS ID 000284881000001
Scopus ID 78349284040
Erfassungsdatum 2010-12-23
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