Unburdening dementia - a basic social process grounded theory based on a primary care physician survey from 25 countries
Petrazzuoli, Ferdinando (Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University)
Vinker, Shlomo (Tel Aviv University. Sackler Faculty of Medicine)
Palmqvist, Sebastian (Lund University. Department of Clinical Sciences in Malmö)
Midlöv, Patrik (Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University)
Lepeleire, Jan De (Department of Public Health and Primary Care, General Practice, University of Leuven)
Pirani, Alessandro (Family and Nursing Home Practice - Memory Clinic, Alzheimer's Association "Francesco Mazzucca" Onlus)
Frese, Thomas (Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg)
Buono, Nicola (SNAMID (National Society of Medical Education in General Practice))
Ahrensberg, Jette (Research Center for Emergency Medicine, Aarhus University)
Asenova, Radost (Department of Urology and General Medicine, Medical University of Plovdiv)
Boreu, Quintí Foguet (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Peker, Gülsen Ceyhun (Department of Family Medicine, Ankara University School of Medicine)
Collins, Claire (Irish College of General Practitioners)
Hanževački, Miro (Director Health Care Center of Zagreb)
Hoffmann, Kathryn (Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna)
Iftode, Claudia (Timis Society of Family Medicine)
Koskela, Tuomas H. (Department of General Practice, University of Tampere)
Kurpas, Donata (Family Medicine Department, Wroclaw Medical University)
Reste, Jean Yves Le (EA 7479 SPURBO. Department of General Practice, Université de Bretagne Occidentale)
Lichtwarck, Bjørn (The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust)
Petek, Davorina (Univerza V Ljubljani)
Schrans, Diego (Department of Family Medicine and Primary, Health Care Ghent University)
Soler, Jean Karl (Mediterranean Institute of Primary Care)
Streit, Sven (Institute of Primary Health Care (BIHAM), University of Bern)
Tatsioni, Athina (Department of Internal Medicine, General Medicine, Faculty of Medicine, University of Ioannina School of Health Sciences)
Torzsa, Péter (Department of Family Medicine, Faculty of Medicine, Semmelweis University)
Unalan, Pemra C. (Department of Family Medicine, Marmara University Medical Faculty)
van Marwijk, Harm (Brighton and Sussex Medical School, University of Brighton)
Thulesius, Hans (Department of Medicine and Optometry, Linnaeus University)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	To explore dementia management from a primary care physician perspective. One-page seven-item multiple choice questionnaire; free text space for every item; final narrative question of a dementia case story. Inductive explorative grounded theory analysis. Derived results in cluster analyses. Appropriateness of dementia drugs assessed by tertiary care specialist. Twenty-five European General Practice Research Network member countries. Four hundred and forty-five key informant primary care physician respondents of which 106 presented 155 case stories. Processes and typologies of dementia management. Proportion of case stories with drug treatment and treatment according to guidelines. Unburdening dementia - a basic social process - explained physicians' dementia management according to a grounded theory analysis using both qualitative and quantitative data. Unburdening starts with Recognizing the dementia burden by Burden Identification and Burden Assessment followed by Burden Relief. Drugs to relieve the dementia burden were reported for 130 of 155 patients; acetylcholinesterase inhibitors or memantine treatment in 89 of 155 patients - 60% appropriate according to guidelines and 40% outside of guidelines. More Central and Northern primary care physicians were allowed to prescribe, and more were engaged in dementia management than Eastern and Mediterranean physicians according to cluster analyses. Physicians typically identified and assessed the dementia burden and then tried to relieve it, commonly by drug prescriptions, but also by community health and home help services, mentioned in more than half of the case stories. Primary care physician dementia management was explained by an Unburdening process with the goal to relieve the dementia burden, mainly by drugs often prescribed outside of guideline indications. Implications: Unique data about dementia management by European primary care physicians to inform appropriate stakeholders.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Dementia ; Drug prescription ; Primary care ; Unburdening ; Elderly people ; Grounded theory
Publicado en:	Scandinavian Journal of Primary Health Care, Vol. 38 Num. 3 (july 2020) , p. 253-264, ISSN 1502-7724

DOI: 10.1080/02813432.2020.1794166
PMID: 32720874

13 p, 1.4 MB

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