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Obstacles to shared care for patients with dementia: a qualitative study
Steve Iliffe1, Jane Wilcock, Deborah Haworth
1Centre for Ageing Population Studies, Department of Primary Care & Population Sciences, Royal Free & UCL Medical School, London, UK. s.iliffe@pcps.ucl.ac.uk
Family Practice
|February 8, 2006
Summary
Shared care for dementia medication faces barriers in general practice, including therapeutic nihilism and resource concerns. Clearer role definitions are needed for effective dementia care protocols.
Area of Science:
- Geriatric Medicine
- Healthcare Management
- Primary Care Research
Background:
- National mandates for shared care protocols for antidementia medications by April 2004 were not fully met.
- Early diagnosis is crucial for dementia shared care, yet under-recognition and under-response are prevalent in general practice.
Purpose of the Study:
- To explore specialist and generalist perspectives on the feasibility of shared care for dementia patients.
- Investigate barriers and facilitators to implementing shared care models in dementia treatment.
Main Methods:
- Qualitative study employing semistructured interviews.
- Thematic and case/cross-case analysis of transcribed interviews from diverse urban and rural settings.
Main Results:
- Interviews with 39 General Practitioners (GPs) and 30 specialists revealed four key themes: therapeutic nihilism, risk management, competency concerns, and resource limitations.
- Resistance to shared care primarily originates from general practice, stemming from issues like time constraints, diagnostic confidence, and staffing.
Conclusions:
- Current professional roles in primary and secondary dementia care require better definition for effective shared care.
- Addressing therapeutic nihilism, risk management, and clinical competence is essential for successful shared care protocol development.
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