RCGP-2014-poster-abstracts

P022
General practitioners’ views on barriers to diagnosing dementia
Anita Chithiramohan; Steve Iliffe; Iram Khattak
University College London
Introduction: Dementia is of increasing clinical relevance in an ageing population but diagnosis rates are
comparatively low. Several studies have identified barriers leading to missed or delayed diagnosis but all were
conducted before recent NHS campaigns specifically targeting the under-­‐diagnosis of dementia. As the first point of
contact for patients with suspected dementia, General Practitioners (GPs) are well placed to understand barriers to
diagnosis.
Aim: To explore GPs’ opinions concerning barriers to diagnosing dementia, in light of recent NHS campaigns.
Design and setting: A qualitative study was undertaken across 2 culturally diverse cities in England. A total of 13 GPs
were interviewed, with 9 individual and 2 group interviews.
Methods: In-­‐depth, semi-­‐structured interviews were conducted face-­‐to-­‐face. Interviews were audiotaped and
transcribed verbatim. Data was analysed independently by 2 investigators using the framework approach and
thematic analysis.
Results: GPs’ reported barriers previously unidentified in the literature, barriers that appear to be consistent with
the literature, as well as barriers that contradicted previous findings. There were 4 major themes: organisational
factors (time constraints, diagnostic tools, primary-­‐secondary care interface, funding, treatability), clinician-­‐related
factors (special interest, doctor-­‐patient relationship), patient-­‐related factors (patient awareness, family, stigma) and
societal influences (cultural factors).
Conclusion: General practitioners perceived recent NHS campaigns to improve dementia diagnosis to be successful
overall in raising awareness of dementia, but identified barriers faced by practicing clinicians in the current
healthcare system. These findings warrant reflection and further investigation.
P023
Can early diagnosis improve dementia care
Halima Choonara; Lovereet Gill
University of Manchester
Aims: With increasing prevalence and awareness of dementia as a public health concern there is a need to improve
the quality of management of dementia. This presentation will look at the management of dementia in primary care,
with specific focus on the benefit of diagnosing dementia early.
Content: The presentation will include findings from a literature review on the current management of dementia,
supported by results from an audit on the time between presentation of dementia symptoms and formal diagnosis.
Relevance: The estimated cost to the UK of dementia care in 2013 was £23 billion. With the awareness of dementia
as a public health concern increasing there has been much interest in improving the quality and efficiency of care
provided. In 2009 the Department of Health (DOH) issued a report entitled ‘Living well with dementia, a National
Dementia Strategy’, which promoted timely diagnosis as a key part of improving dementia care.
Discussion: Results from the audit found on average a 19 month delay between symptom presentation and
diagnosis. Barriers to diagnosis exist from both patients and practitioners that can be attributed to this. While there
is a lack of quantitative data to support the benefits of early diagnosis, current expert opinion is that early diagnosis
can optimise overall care.
Outcome: It appears there is a reluctance to diagnose dementia early. However, early diagnosis is a notion
supported by the DOH and the Wold Alzheimer’s Report 2011 that could prove pivotal in improving dementia care
and outcomes.
P024
Polypharmacy review in a Medway nursing home
Harkiran Sohal; Chidambaram Balachander; Sanjay Suman
Borstal Village Surgery; Medway NHS Foundation Trust
Aims and objective: To identify residents with polypharmacy (≥4 medications), any adverse drug reactions (ADR)
noted and whether a formal medication review was performed in the last 6 months.
26