Enhancing Dementia Care in Primary Care: Impact of Targeted Training and Electronic Medical Record (EMR)-Integrated...

The number of medical specialists whose training programs provide robust education in dementia diagnosis and treatment pales in comparison to the increasing number of individuals living with dementia. Primary care providers (PCPs) care for most older adults with cognitive concerns and dementia. Summarized here are the results of an effort to help PCPs care for these patients using targeted training and electronic medical record (EMR)-integrated clinical algorithms.

Clinicians from two University of California San Diego Family Medicine Clinics completed assessments of dementia knowledge and comfort in caring for patients and family members impacted by dementia four times: enrollment, and approximately two, nine and 15 months after a three-component intervention: 1) training via four online educational modules (six hours total) on screening, evaluation, and care of patients with dementia; 2) integration of clinical algorithms into the EMR system and 3) access to mentoring from a more experienced peer.

Subjective assessment of comfort and competence of intervention group clinicians in working with patients with cognitive complaints significantly increased and was higher for intervention group PCPs than the comparison group PCPs. Evidence of completed AD8s (Eight-Item Informant Interview to Differentiate Aging and Dementia) at both clinics increased from baseline to post-intervention: 52.85% to 82.6% and 66.1% to 86.9%.

Training PCPs on dementia screening and diagnosis, and integration of algorithms into the EMR, improved clinician subjective competence and comfort in caring for patients with cognitive complaints and increased the AD8 completion rate. The small number of study participants mandates caution when interpreting these findings.