Are patients with dementia treated as well as patients without dementia for hypertension, diabetes, and hyperlipidaemia?
BACKGROUND
Patients suffering from dementia are at risk of being treated differently by GPs from patients without it. Explanations for this could be stigmatisation, treatment with a palliative approach, and the result of the disease process.


OBJECTIVE
To ascertain whether patients with dementia are treated differently, the index diseases of hypertension, diabetes, and hyperlipidaemia were used to measure care.


METHODS
Retrospective matched control study.


METHODS
German general practice.


METHODS
Sixteen GP practices recruited all their patients with dementia and at least one of the index diseases. Patients without dementia but only the index diseases were matched for age, sex, index disease, and practice, resulting in 216 pairs of patients with and without dementia. From the files, blood pressure, blood sugar/glycated haemoglobin, cholesterol, the dates of measurement, the number of doctor-patient contacts, and the prescribed medication to treat the three conditions under scrutiny were documented. For analysis, t-tests and χ(2)-tests were used.


RESULTS
No differences were found in treatment outcomes between the two patients groups, except one significant difference: one of the two documented systolic blood pressure values is lower in the dementia group. Furthermore, patients with dementia more often do not receive any medication or are treated with low-priced medications for hypertension (nearly significant).


CONCLUSIONS
GPs do not seem to treat patients with dementia differently. The use of lower-priced antihypertensive medication could be the only indication for some kind of difference in approach.
Müther
Johannes
J
University Hospital Düsseldorf, Department of General Practice, Heinrich-Heine-University Düsseldorf, Germany.
Abholz
Heinz-Harald
HH
Wiese
Birgitt
B
Fuchs
Angela
A
Wollny
Anja
A
Pentzek
Michael
M
D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002491:Central Nervous System Agents / Q000627:therapeutic use; D003704:Dementia / Q000628:therapy*; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D058006:General Practice / Q000592:standards*; D006801:Humans; D006949:Hyperlipidemias / Q000628:therapy*; D006973:Hypertension / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D011787:Quality of Health Care; D012189:Retrospective Studies; D013240:Stereotyping
D000959:Antihypertensive Agents; D002491:Central Nervous System Agents; D007004:Hypoglycemic Agents