Title | Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care. |
Publication Type | Journal Article |
Year of Publication | 2023 |
Authors | Sideman, ABernstein, Ma, M, de Jesus, AHernandez, Alagappan, C, Razon, N'amah, Dohan, D, Chodos, A, Al-Rousan, T, Alving, LI, Segal-Gidan, F, Rosen, H, Rankin, KP, Possin, KL, Borson, S |
Journal | JAMA Netw Open |
Volume | 6 |
Issue | 9 |
Pagination | e2336030 |
Date Published | 2023 Sep 05 |
ISSN | 2574-3805 |
Keywords | Dementia, Female, Health Personnel, Humans, Male, Physician's Role, Physicians, Primary Care, Primary Health Care, United States |
Abstract | IMPORTANCE: Although the barriers to dementia care in primary care are well characterized, primary care practitioner (PCP) perspectives could be used to support the design of values-aligned dementia care pathways that strengthen the role of primary care. OBJECTIVE: To describe PCP perspectives on their role in dementia diagnosis and care. DESIGN, SETTING, AND PARTICIPATION: In this qualitative study, interviews were conducted with 39 PCPs (medical doctors, nurse practitioners, and doctors of osteopathic medicine) in California between March 2020 and November 2022. Results were analyzed using thematic analysis. MAIN OUTCOMES AND MEASURES: Overarching themes associated with PCP roles in dementia care. RESULTS: Interviews were conducted with 39 PCPs (25 [64.1%] were female; 16 [41%] were Asian). The majority (36 PCPs [92.3%]) reported that more than half of their patients were insured via MediCal, the California Medicaid program serving low-income individuals. Six themes were identified that convey PCPs' perspectives on their role in dementia care. These themes focused on (1) their role as first point of contact and in the diagnostic workup; (2) the importance of long-term, trusting relationships with patients; (3) the value of understanding patients' life contexts; (4) their work to involve and educate families; (5) their activities around coordinating dementia care; and (6) how the care they want to provide may be limited by systems-level constraints. CONCLUSIONS AND RELEVANCE: In this qualitative study of PCP perspectives on their role in dementia care, there was alignment between PCP perspectives about the core values of primary care and their work diagnosing and providing care for people living with dementia. The study also identified a mismatch between these values and the health systems infrastructure for dementia care in their practice environment. |
DOI | 10.1001/jamanetworkopen.2023.36030 |
Alternate Journal | JAMA Netw Open |
PubMed ID | 37768660 |
PubMed Central ID | PMC10539983 |
Grant List | K01 AG059840 / AG / NIA NIH HHS / United States K07 AG066814 / AG / NIA NIH HHS / United States KL2 TR001859 / TR / NCATS NIH HHS / United States UL1 TR001860 / TR / NCATS NIH HHS / United States R35 AG072362 / AG / NIA NIH HHS / United States K23 HL148530 / HL / NHLBI NIH HHS / United States U01 NS128913 / NS / NINDS NIH HHS / United States R01 AG056715 / AG / NIA NIH HHS / United States |