scholarly journals Psychotropic drug prescription rates in primary care for people with dementia from recorded diagnosis onwards

2020 ◽  
Author(s):  
Karlijn J. Joling ◽  
Maud ten Koppel ◽  
Hein P.J. van Hout ◽  
Bregje D. Onwuteaka‐Philipsen ◽  
Anneke L. Francke ◽  
...  
Keyword(s):  
Primary Care ◽  
Psychotropic Drug ◽  
Drug Prescription ◽  
People With Dementia ◽  
Prescription Rates ◽  
Recorded Diagnosis

scholarly journals Effects of a Dementia Screening Program on Healthcare Utilization in South Korea: A Difference-In-Difference Analysis

2019 ◽  
Vol 16 (20) ◽  
pp. 3837 ◽  
Author(s):  
Su Jung Lee ◽  
Hyun-Ju Seo ◽  
Dong Young Lee ◽  
So-Hyun Moon
Keyword(s):  
Screening Program ◽  
Drug Prescription ◽  
Healthcare Services ◽  
Control Group ◽  
Difference In Difference ◽  
Difference Analysis ◽  
Screening Programs ◽  
Dementia Screening ◽  
People With Dementia ◽  
Prescription Rates

To determine whether Seoul’s dementia screening program increased the rate of diagnosis and the appropriate use of healthcare services for people with dementia, a retrospective data analysis was conducted based on administrative data from the Health Insurance Review and Assessment Service. Two cohorts were constructed to represent the year before Seoul’s dementia screening program began (2007) (control group) and the year after the implementation of the program (2009) (treatment group). A difference-in-difference analysis was used to compare the diagnosis rates, number of clinic visits, and dementia-related drug prescription rates for 4 districts that implemented dementia screening programs between 2007 and 2009 and 14 areas that did not. After the introduction of the program, there was a 55.4% increase in physician-diagnosed dementia. The “average drug cost per patient” increased by 52.2% (Exp(β) = 1.522, p = 0.0264), the “average outpatient visits per patient” tended to increase by 13.5% (Exp(β) = 1.135, p = 0.1852), and the “average outpatient treatment fees per visit per patient” tended to increase by 24.4% (Exp(β) = 1.244, p = 0.0821). The implementation of dementia screening programs led to an increase in healthcare service utilization. Therefore, this program was found to be an effective strategy for reducing undiagnosed dementia cases and encouraging patients to use adequate healthcare services.

Psychotropic drug prescription in primary care

1996 ◽  
Vol 11 ◽  
pp. 179s
Author(s):  
M. Linden ◽  
Y. Lecrubier ◽  
C. Bellantuono ◽  
O. Benkert ◽  
S. Kisley ◽  
...  
Keyword(s):  
Primary Care ◽  
Psychotropic Drug ◽  
Drug Prescription

scholarly journals Pharmacotherapy of borderline personality disorder: what has changed over two decades? A retrospective evaluation of clinical practice

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Charles Timäus ◽  
Miriam Meiser ◽  
Borwin Bandelow ◽  
Kirsten R. Engel ◽  
Anne M. Paschke ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychotropic Drug ◽  
Inpatient Treatment ◽  
Medical Center ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Main Diagnosis ◽  
Tetracyclic Antidepressants ◽  
Prescription Rates

Abstract Background The purpose of this study was to assess the pharmacological treatment strategies of inpatients with borderline personality disorder between 2008 and 2012. Additionally, we compared pharmacotherapy during this period to a previous one (1996 to 2004). Methods Charts of 87 patients with the main diagnosis of borderline personality disorder receiving inpatient treatment in the University Medical Center of Goettingen, Germany, between 2008 and 2012 were evaluated retrospectively. For each inpatient treatment, psychotropic drug therapy including admission and discharge medication was documented. We compared the prescription rates of the interval 2008–2012 with the interval 1996–2004. Results 94% of all inpatients of the interval 2008–2012 were treated with at least one psychotropic drug at time of discharge. All classes of psychotropic drugs were applied. We found high prescription rates of naltrexone (35.6%), quetiapine (19.5%), mirtazapine (18.4%), sertraline (12.6%), and escitalopram (11.5%). Compared to 1996–2004, rates of low-potency antipsychotics, tri−/tetracyclic antidepressants and mood stabilizers significantly decreased while usage of naltrexone significantly increased. Conclusions In inpatient settings, pharmacotherapy is still highly prevalent in the management of BPD. Prescription strategies changed between 1996 and 2012. Quetiapine was preferred, older antidepressants and low-potency antipsychotics were avoided. Opioid antagonists are increasingly used and should be considered for further investigation.

scholarly journals Outcomes of Primary Care for People With Dementia: What’s Important?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 164-165
Author(s):  
Laura Wray ◽  
Bonnie Vest ◽  
Laura Brady ◽  
Christina Vair ◽  
Gregory Beehler ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health And Safety ◽  
Limited Attention ◽  
Veterans Health ◽  
Cognitive Screening ◽  
Health Administration ◽  
People With Dementia ◽  
Primary Care Teams ◽  
Care Outcomes

Abstract People with dementia (PWD) typically receive most of their healthcare in primary care (PC), but neurocognitive disorders can be challenging to recognize, assess, and manage in that setting. As a result, cognitive impairment in older adults is often missed or not addressed until later stages. The result is poor management of comorbid health conditions, increased healthcare utilization, and negative outcomes for the patient and family. Further, strategies for improvement and barriers to high quality PC for PWD have received limited attention. To improve PC for PWD, it is essential to understand what care outcomes should be targeted. To address this gap, we used a qualitative approach to examine potential outcomes of PC from the perspectives of older adults, family caregivers, primary care teams, and geriatrics specialists (n=79) from two Veterans Health Administration healthcare systems. Participants were interviewed individually or in focus groups. A directed content analysis based on the adapted Donabedian model was employed and expanded to fully capture transcript content. Three main categories of outcomes were identified: Personhood (i.e., independence), Physical Health and Safety, and Quality of Life. Regardless of participant type, respondents focused on similar desired outcomes and, notably, identified outcomes as important for both patients and their broader social context (i.e., caregivers, family). Discussion will: show how findings align with work conducted in specialty and residential care; describe how challenges to attaining these outcomes in PC can be overcome; and, challenge cognitive screening recommendations for PC that are based primarily on risk/benefit analysis of medication-focused outcomes.

scholarly journals Consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mireia Massot Mesquida ◽  
Montserrat Tristany Casas ◽  
Alicia Franzi Sisó ◽  
Isabel García Muñoz ◽  
Óscar Hernández Vian ◽  
...  
Keyword(s):  
Psychotropic Drug ◽  
Medication Review ◽  
Drug Prescription ◽  
Evidence Based ◽  
Dementia Patients

scholarly journals Psychotropic drug use among people with dementia – a six-month follow-up study

2013 ◽  
Vol 14 (1) ◽  
Author(s):  
Maria Gustafsson ◽  
Stig Karlsson ◽  
Yngve Gustafson ◽  
Hugo Lövheim
Keyword(s):  
Drug Use ◽  
Psychotropic Drug ◽  
Follow Up Study ◽  
Psychotropic Drug Use ◽  
People With Dementia

scholarly journals Clinical practice guidelines and principles of care for people with dementia: a protocol for undertaking a Delphi technique to identify the recommendations relevant to primary care nurses in the delivery of person-centred dementia care

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044843
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Mark William Yates ◽  
Dimity Pond
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Dementia Care ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
People With Dementia ◽  
Primary Care Nurses

IntroductionNationally and internationally it is well recognised that dementia is poorly recognised and suboptimally managed in the primary care setting. There are multiple and complex reasons for this gap in care, including a lack of knowledge, high care demands and inadequate time for the general practitioner alone to manage dementia with its multiple physical, psychological and social dimensions. The primary care nurse potentially has a role in assisting the general practitioner in the provision of evidence-based dementia care. Although dementia-care guidelines for general practitioners exist, evidence on resources to support the primary care nurse in dementia care provision is scarce. The ‘Australian Clinical Practice Guidelines and Principles of Care for People with Dementia’ provides 109 recommendations for the diagnosis and management of dementia. This protocol describes a Delphi study to identify which of the 109 recommendations contained in these multidisciplinary guidelines are relevant to the primary care nurse in the delivery of person-centred dementia care in the general practice setting.Methods and analysisUsing a Delphi consensus online survey, an expert panel will grade each of the recommendations written in the ‘Clinical Practice Guidelines and Principles of Care for People with Dementia’ as high-to-low relevance with respect to the role of the primary care nurse in general practice. To optimise reliability of results, quality indicators will be used in the data collection and reporting of the study. Invited panel members will include Australian primary care nurses working in general practice, primary care nursing researchers and representatives of the Australian Primary Health Care Nurses Association, the peak professional body for nurses working in primary healthcare.Ethics and disseminationThis study has been approved by The University of Newcastle Human Research Ethics Committee (HREC) (H-2019-0029).Findings will be published in a peer-reviewed journal and presented at scientific conferences.

scholarly journals Factors influencing general practitioners’ perception of and attitude towards dementia diagnostics and care—results of a survey among primary care physicians in Germany

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Influencing Factors ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Descriptive Analysis ◽  
Linear Regression Analysis ◽  
Interdisciplinary Cooperation ◽  
Practice Staff ◽  
People With Dementia ◽  
Dementia Diagnostics

SummaryStudies have shown that primary care is not always effective when it comes to caring for people with dementia. In addition, general practitioners do not always use diagnostic instruments consistently. The aim of the study was to identify relevant factors that influence general practitioners’ attitudes and willingness with respect to consistent diagnosis and care. For this purpose, resources, viewpoints, and behavioral patterns of general practitioners with regard to dementia diagnostics as well as common challenges in everyday practice were recorded. In the course of a survey, a total of 2266 general practitioners in Hesse and Baden-Württemberg were interviewed between January and March 2020. In addition to the descriptive analysis, a t-test was used to determine significant differences between two groups. A univariate linear regression analysis was carried out to identify possible influencing factors. 81% of the respondents do provide dementia diagnostics; 51% are involved in the treatment. Most of them see the diagnostic work-up (77%), communication and compliance problems (73%), as well as the therapeutic support (71%) as common challenges. In addition, there are interface problems regarding the interdisciplinary cooperation. Some of the respondents express doubts about the value of early detection (41%). The general practitioners’ attitude with respect to dementia diagnostics and care is determined by influencing factors that relate to geriatric competencies, expectations of self-efficacy, the integration of practice staff, as well as the knowledge of and cooperation with counseling and care services. It seems advisable to strengthen the geriatric competence of general practitioners. Moreover, it appears essential to educate general practitioners more about support structures in the field of dementia care and to integrate them accordingly. In addition, practice staff should be more systematically involved in the identification and care of dementia patients.

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