The management of dementia by flemish GPs: it remains a difficult job

De Lepeleire Jan, Despriet Delfine, Van De Putte Eileen, Van Eecke Herlinde, Steyaert Jan, Schoenmakers Birgitte
Acta Clinica Belgica 2020 January 30, : 1-8
Objective : The following study examines how GPs in Flanders deal with dementia in terms of detection, diagnosis, care diagnosis and treatment. Methods : An online survey was sent out by mail to 5113 Flemish GP's. Data were collected in 2016. The results were processed in a univariate and multivariate analysis with SAS 9.4 Results : 331 GPs completed the survey in full (response rate 6.47%). The results are representative of GPs of the Flemish Region in terms of distribution across the provinces and university of graduation. 82.78% use the MMSE and 5.44% the DSM criteria. A blood analysis was performed by 80.97%, aCT or MRI by 23.56% and 17,22% respectively. Nine out of 331 mapped out the full care planning. The Katz scale was used rarely or never by 25.38%. The physical condition of the caregivers was enquired about by 91.69% and their mental state by 96.92%. Acetylcholinesterase inhibitors were prescribed by 94.56%, memantine by 57.70%, ginkgo biloba by 49.85%. 89.73% prefers a medical approach for hallucinations and delusions, 65.26% for aggression, 50.78% for agitation, 71.30% for depression and 48.34% for sleep disorders. Older GPs felt their knowledge was insufficient and used more pharmacological treatments. Conclusion : GPs are unfamiliar with available detection and diagnostic possibilities. GPs include history taking of carers but underuse available support tools, biochemical analyses and imaging. Post diagnostic care is mapped out insufficiently, despite the fact that GPs focus adequately on their patients' caregivers. In the pharmacological treatment there is a notable discrepancy between what GPs think and do. Pharmacological policy in behavioural bymptoms is most common. GPs highly value the possibility of receiving support by reference physicians.

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