[Improving general practitioners guided dementia care: the pilot project start-modem in Rheinland-Pfalz, Germany].
BACKGROUND
The study examined the ability of trained General Practitioners (GPs) to carry out guideline based diagnostics and therapy of dementia. The article reports the GP-related findings.


METHODS
100 GPs took part in the prospective multi-centre study. 34 GPs started self-guided medical dementia care after attending a special training. The control group of 66 GPs referred patients suspected of dementia to specialist centres. Time of recruiting was 13 months. In case of dementia diagnosis patients and caregivers received professional psychosocial counselling.


RESULTS
Trained GPs reported improvements of sensitization and qualification through the project. The cross-linkage of GPs' medical dementia care and psychosocial counselling found a broad acceptance of the participants (GPs, patients, caregivers). 92 of the 156 included patients were diagnosed as dementia. Guideline conformity was violated in 65.4 % of all cases concerning structural imaging and in 30.1 % regarding laboratory tests. "Unspecified Dementia" was the most frequent ICD-10-diagnosis by GPs.


CONCLUSIONS
Despite the broad acceptance of the project a limited guideline-conformity as well as the diagnostic uncertainty suggests that the implemented training is only a first step towards GP guided dementia care. To extend GPs guided dementia care and to improve the quality of GPs dementia diagnostics and therapy sensitization of more GPs for active dementia care as well as supervised practical training will be necessary.
Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz.
N
N
Laux
H
H
Melchinger
A
A
Scheurich
I
I
Schermuly
I
I
Germann
S
S
Hilgert
K
K
Lieb
A
A
Fellgiebel
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000193:education; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education*; D005260:Female; D058005:General Practitioners; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011368:Professional-Family Relations; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation