Quality of care provided to people with dementia: Utilisation and quality of the annual dementia review in general practice

Amanda Connolly, Steve Iliffe, Ella Gaehl, Stephen Campbell, Richard Drake, Julie Morris, Helen Martin, Nitin Purandare

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Primary care services are often the main healthcare service for people with dementia; as such, good-quality care at this level is important.

Aim To measure the quality of care provided to people with dementia in general practice using routinely collected data, and to explore associated patient and practice factors.

Design and setting Observational, cross-sectional review of medical records from general practices (n = 52) in five primary care trusts.

Method A total of 994 people with dementia were identified from dementia registers. An unweighted quality-of-care score was constructed using information collected in the annual dementia review, together with pharmacological management of cognitive and non-cognitive symptoms. Multilevel modelling was carried out to identify factors associated with quality-of-care scores.

Results In total, 599 out of 745 (80%) patients with dementia had received an annual dementia review; however, a social care review or discussion with carers was evident in just 305 (51%) and 367 (61%) of those 599 cases, respectively. Despite high prevalence of vascular disease, over a quarter (n = 259, 26%) of all patients with dementia were prescribed antipsychotics; only 57% (n = 148) of these had undergone medication review in the previous 6 months. Those with vascular dementia who were registered with single-handed practices received poorer quality of care than those registered with practices that had more than one GP.

Conclusion Although the number of people with dementia with a record of an annual dementia review is high, the quality of these reviews is suboptimal. The quality score developed in this study could be used as one source of data to identify weaknesses in practice activity that need to be corrected, and so would be of value to commissioners and regulators, as well as practices themselves
Original languageEnglish
Pages (from-to)91-98
Number of pages8
JournalBritish Journal of General Practice
Volume62
Issue number595
DOIs
Publication statusPublished - 2012
Externally publishedYes

Fingerprint

Quality of Health Care
General Practice
Dementia
Primary Health Care
Vascular Dementia
Information Storage and Retrieval
Vascular Diseases
Caregivers
Antipsychotic Agents
Medical Records
Pharmacology
Delivery of Health Care

Cite this

Connolly, Amanda ; Iliffe, Steve ; Gaehl, Ella ; Campbell, Stephen ; Drake, Richard ; Morris, Julie ; Martin, Helen ; Purandare, Nitin. / Quality of care provided to people with dementia: Utilisation and quality of the annual dementia review in general practice. In: British Journal of General Practice. 2012 ; Vol. 62, No. 595. pp. 91-98.
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title = "Quality of care provided to people with dementia: Utilisation and quality of the annual dementia review in general practice",
abstract = "Background Primary care services are often the main healthcare service for people with dementia; as such, good-quality care at this level is important.Aim To measure the quality of care provided to people with dementia in general practice using routinely collected data, and to explore associated patient and practice factors.Design and setting Observational, cross-sectional review of medical records from general practices (n = 52) in five primary care trusts.Method A total of 994 people with dementia were identified from dementia registers. An unweighted quality-of-care score was constructed using information collected in the annual dementia review, together with pharmacological management of cognitive and non-cognitive symptoms. Multilevel modelling was carried out to identify factors associated with quality-of-care scores.Results In total, 599 out of 745 (80{\%}) patients with dementia had received an annual dementia review; however, a social care review or discussion with carers was evident in just 305 (51{\%}) and 367 (61{\%}) of those 599 cases, respectively. Despite high prevalence of vascular disease, over a quarter (n = 259, 26{\%}) of all patients with dementia were prescribed antipsychotics; only 57{\%} (n = 148) of these had undergone medication review in the previous 6 months. Those with vascular dementia who were registered with single-handed practices received poorer quality of care than those registered with practices that had more than one GP.Conclusion Although the number of people with dementia with a record of an annual dementia review is high, the quality of these reviews is suboptimal. The quality score developed in this study could be used as one source of data to identify weaknesses in practice activity that need to be corrected, and so would be of value to commissioners and regulators, as well as practices themselves",
author = "Amanda Connolly and Steve Iliffe and Ella Gaehl and Stephen Campbell and Richard Drake and Julie Morris and Helen Martin and Nitin Purandare",
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Connolly, A, Iliffe, S, Gaehl, E, Campbell, S, Drake, R, Morris, J, Martin, H & Purandare, N 2012, 'Quality of care provided to people with dementia: Utilisation and quality of the annual dementia review in general practice', British Journal of General Practice, vol. 62, no. 595, pp. 91-98. https://doi.org/10.3399/bjgp12X625148

Quality of care provided to people with dementia: Utilisation and quality of the annual dementia review in general practice. / Connolly, Amanda; Iliffe, Steve; Gaehl, Ella; Campbell, Stephen; Drake, Richard; Morris, Julie; Martin, Helen; Purandare, Nitin.

In: British Journal of General Practice, Vol. 62, No. 595, 2012, p. 91-98.

Research output: Contribution to journalArticle

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T1 - Quality of care provided to people with dementia: Utilisation and quality of the annual dementia review in general practice

AU - Connolly, Amanda

AU - Iliffe, Steve

AU - Gaehl, Ella

AU - Campbell, Stephen

AU - Drake, Richard

AU - Morris, Julie

AU - Martin, Helen

AU - Purandare, Nitin

PY - 2012

Y1 - 2012

N2 - Background Primary care services are often the main healthcare service for people with dementia; as such, good-quality care at this level is important.Aim To measure the quality of care provided to people with dementia in general practice using routinely collected data, and to explore associated patient and practice factors.Design and setting Observational, cross-sectional review of medical records from general practices (n = 52) in five primary care trusts.Method A total of 994 people with dementia were identified from dementia registers. An unweighted quality-of-care score was constructed using information collected in the annual dementia review, together with pharmacological management of cognitive and non-cognitive symptoms. Multilevel modelling was carried out to identify factors associated with quality-of-care scores.Results In total, 599 out of 745 (80%) patients with dementia had received an annual dementia review; however, a social care review or discussion with carers was evident in just 305 (51%) and 367 (61%) of those 599 cases, respectively. Despite high prevalence of vascular disease, over a quarter (n = 259, 26%) of all patients with dementia were prescribed antipsychotics; only 57% (n = 148) of these had undergone medication review in the previous 6 months. Those with vascular dementia who were registered with single-handed practices received poorer quality of care than those registered with practices that had more than one GP.Conclusion Although the number of people with dementia with a record of an annual dementia review is high, the quality of these reviews is suboptimal. The quality score developed in this study could be used as one source of data to identify weaknesses in practice activity that need to be corrected, and so would be of value to commissioners and regulators, as well as practices themselves

AB - Background Primary care services are often the main healthcare service for people with dementia; as such, good-quality care at this level is important.Aim To measure the quality of care provided to people with dementia in general practice using routinely collected data, and to explore associated patient and practice factors.Design and setting Observational, cross-sectional review of medical records from general practices (n = 52) in five primary care trusts.Method A total of 994 people with dementia were identified from dementia registers. An unweighted quality-of-care score was constructed using information collected in the annual dementia review, together with pharmacological management of cognitive and non-cognitive symptoms. Multilevel modelling was carried out to identify factors associated with quality-of-care scores.Results In total, 599 out of 745 (80%) patients with dementia had received an annual dementia review; however, a social care review or discussion with carers was evident in just 305 (51%) and 367 (61%) of those 599 cases, respectively. Despite high prevalence of vascular disease, over a quarter (n = 259, 26%) of all patients with dementia were prescribed antipsychotics; only 57% (n = 148) of these had undergone medication review in the previous 6 months. Those with vascular dementia who were registered with single-handed practices received poorer quality of care than those registered with practices that had more than one GP.Conclusion Although the number of people with dementia with a record of an annual dementia review is high, the quality of these reviews is suboptimal. The quality score developed in this study could be used as one source of data to identify weaknesses in practice activity that need to be corrected, and so would be of value to commissioners and regulators, as well as practices themselves

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DO - 10.3399/bjgp12X625148

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EP - 98

JO - Journal of the Royal College of General Practitioners

JF - Journal of the Royal College of General Practitioners

SN - 0960-1643

IS - 595

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