title: Improving dementia diagnosis and management in primary care: a cohort study of the impact of a training and support program on physician competency, practice patterns, and community linkages.
abstract: BACKGROUND
  Primary care physicians routinely provide dementia care, but may lack the clinical skills and awareness of available resources to provide optimal care. We conducted a community-based pilot dementia training intervention designed to both improve clinical competency and increase utilization of local dementia care services.
  
  
  METHODS
  Physicians (N = 29) and affiliated staff (N = 24) participated in a one-day training program on dementia screening, diagnosis and management that included direct engagement with local support service providers. Questionnaires about their dementia care competency and referral patterns were completed before and 6 months after the training intervention.
  
  
  RESULTS
  Physicians reported significantly higher overall confidence in their dementia care competency 6 months post-training compared to pre-training. The largest reported improvements were in their ability to educate patients and caregivers about dementia and making appropriate referrals to community care services. Participants also reported markedly increased use of cognitive screening tools in providing care. Community service providers recorded approximately 160 physician-initiated referrals over a 2 year-period post-training, compared to few beforehand.
  
  
  CONCLUSIONS
  Combining a targeted physician practice-based educational intervention with community service engagement improves dementia care competency in clinicians and promotes linkages between clinical and community dementia care providers.
authors: Program on Aging, Disability, and Long-Term Care, Cecil G, Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, CB# 7590, 725 Martin Luther King Jr, Blvd,, Chapel Hill, NC 27599-7590, USA. lathren@schsr.unc.edu.
authors: Christine R
authors: CR
authors: Lathren
authors: Philip D
authors: PD
authors: Sloane
authors: Joseph D
authors: JD
authors: Hoyle
authors: Sheryl
authors: S
authors: Zimmerman
authors: Daniel I
authors: DI
authors: Kaufer
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D012111:Residence Characteristics