TY - JOUR
T1 - A new model for general practice-led, regional, community-based, memory clinics
AU - Disler, Rebecca
AU - Pascoe, Amy
AU - Anderson, Holly
AU - Piejko, Ewa
AU - Asaid, Adel
AU - Disler, Peter
N1 - Funding Information:
This model and project was undertaken as a collaboration between Monash School of Rural Health, University of Melbourne, Department of Rural Health, La Trobe University, Murray Primary Health Network and St Anthony Medical Practices and Memory Clinic.
Funding Information:
The program described in this paper sought to increase GP access to specialist advice, both through the co-location of a geriatrician and psycho-geriatrician specialists consulting within the primary setting, and through informal as-needed dialogue either in person or on the telephone. The program was also planned to remove barriers to patient attendance for dementia screening, by locating this within the general practice location, which was familiar and provided adequate free parking, and with no financial disincentive by funding specialist consultations through the Medicare program. The new model of care described in this paper was developed in a multi-site regional and rural general practice and aims to incorporate training and the use of standardised tools within primary care to address the limited access to screening and management of dementia in the community setting.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Dementia is a major international health issue with high impact on the patient, relatives, and broader society. Routine screening for dementia is limited, despite known benefit of early detection and intervention on quality of care and patient outcomes. Screening is particularly limited in rural and regional areas, despite high burden and projected growth of dementia in these populations. The current study aimed to implement a new general practitioner (GP) led, multidisciplinary, model of care providing dementia detection and referral pathway to a community-based specialist clinic across six regional general practices. Methods: Cross-sectional analysis of dementia screening and referral characteristics in the St Anthony Family Medical Practices group based in the regional area of Loddon-Mallee, Victoria. Data were collected on demographics and relevant medical history. Cognitive state was assessed using the Mini-Mental State Examination (MMSE), GP Assessment of Cognition (GPCog), and Geriatric Depression Scale (GDS). Referrals and referral outcomes were recorded for geriatrician, psycho-geriatrician, or both. Results: Eight hundred and eighteenth patients over 65 years were screened, accounting for approximately 24.2% of 65 and over presentations for the practice network. Of those screened, 68.9% were indicated for referral and 30.3% of these were successfully referred. Of the indicated patients who received referrals, 34.2% declined. Many who declined referral had intermediate scores on the cognitive assessments utilized. Conclusion: Standardised models of care, integrated within community services, are necessary to improve access to early detection, referral and quality management of dementia. The St Anthony Memory Service model will be invaluable in informing future service development, and in particular the development of services for people living with dementia in rural and regional communities.
AB - Background: Dementia is a major international health issue with high impact on the patient, relatives, and broader society. Routine screening for dementia is limited, despite known benefit of early detection and intervention on quality of care and patient outcomes. Screening is particularly limited in rural and regional areas, despite high burden and projected growth of dementia in these populations. The current study aimed to implement a new general practitioner (GP) led, multidisciplinary, model of care providing dementia detection and referral pathway to a community-based specialist clinic across six regional general practices. Methods: Cross-sectional analysis of dementia screening and referral characteristics in the St Anthony Family Medical Practices group based in the regional area of Loddon-Mallee, Victoria. Data were collected on demographics and relevant medical history. Cognitive state was assessed using the Mini-Mental State Examination (MMSE), GP Assessment of Cognition (GPCog), and Geriatric Depression Scale (GDS). Referrals and referral outcomes were recorded for geriatrician, psycho-geriatrician, or both. Results: Eight hundred and eighteenth patients over 65 years were screened, accounting for approximately 24.2% of 65 and over presentations for the practice network. Of those screened, 68.9% were indicated for referral and 30.3% of these were successfully referred. Of the indicated patients who received referrals, 34.2% declined. Many who declined referral had intermediate scores on the cognitive assessments utilized. Conclusion: Standardised models of care, integrated within community services, are necessary to improve access to early detection, referral and quality management of dementia. The St Anthony Memory Service model will be invaluable in informing future service development, and in particular the development of services for people living with dementia in rural and regional communities.
KW - Dementia
KW - Dementia screening
KW - General practice
KW - Models of care
KW - Primary care
UR - https://www.scopus.com/pages/publications/85138144747
U2 - 10.1186/s12875-022-01829-1
DO - 10.1186/s12875-022-01829-1
M3 - Article
C2 - 36127660
AN - SCOPUS:85138144747
SN - 2731-4553
VL - 23
JO - BMC Primary Care
JF - BMC Primary Care
IS - 1
M1 - 242
ER -