Under-provision of medical care for vascular diseases for people with dementia in primary care: A cross-sectional review

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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Vascular diseases contribute to the causation and progression of clinical dementia.

Aim To evaluate the quality of medical care for vascular diseases provided to people with dementia, the patient and practice characteristics that influence quality, and to compare care with that provided to those without dementia.

Design and setting Observational, cross-sectional review of primary care records of people with dementia from 52 general practices from five primary care trusts in the UK, and comparison with publicly available summary data on patients without dementia.

Method A total of 700 patients with ≥1 diagnosed vascular disease or risk factor were identified from dementia registers. Quality of care was measured on 30 indicators from the UK Quality and Outcomes Framework (QOF) for hypertension, coronary heart disease, stroke, diabetes mellitus, atrial fibrillation, heart failure, and smoking. Overall quality of vascular care was calculated for each patient with dementia.

Result Level of care received by people with dementia was significantly lower compared with those without dementia for 22 of 30 (73%) indicators; most notably for measurement processes such as peripheral pulses check and neuropathy testing for diabetes, and cholesterol measures for stroke. Among people with dementia, women, those in care homes, and those with fewer comorbid physical conditions and medications were associated with lower scores for overall quality of vascular care.

Conclusion The quality of medical care provided to people with dementia with regard to vascular diseases is not concordant with quality, as defined by the QOF. Research is needed to improve access to high-quality care
Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalBritish Journal of General Practice
Volume63
Issue number607
DOIs
Publication statusPublished - 2013
Externally publishedYes

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Vascular Diseases
Dementia
Primary Health Care
Quality of Health Care
Blood Vessels
Stroke
Home Care Services
General Practice
Causality
Atrial Fibrillation
Coronary Disease
Diabetes Mellitus
Heart Failure
Smoking
Cholesterol
Hypertension

Cite this

Connolly, Amanda ; Campbell, Stephen ; Gaehl, Ella ; Iliffe, Steve ; Drake, Richard ; Morris, Julie ; Martin, Helen ; Purandare, Nitin. / Under-provision of medical care for vascular diseases for people with dementia in primary care: A cross-sectional review. In: British Journal of General Practice. 2013 ; Vol. 63, No. 607. pp. 1-9.
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abstract = "Background Vascular diseases contribute to the causation and progression of clinical dementia.Aim To evaluate the quality of medical care for vascular diseases provided to people with dementia, the patient and practice characteristics that influence quality, and to compare care with that provided to those without dementia.Design and setting Observational, cross-sectional review of primary care records of people with dementia from 52 general practices from five primary care trusts in the UK, and comparison with publicly available summary data on patients without dementia.Method A total of 700 patients with ≥1 diagnosed vascular disease or risk factor were identified from dementia registers. Quality of care was measured on 30 indicators from the UK Quality and Outcomes Framework (QOF) for hypertension, coronary heart disease, stroke, diabetes mellitus, atrial fibrillation, heart failure, and smoking. Overall quality of vascular care was calculated for each patient with dementia.Result Level of care received by people with dementia was significantly lower compared with those without dementia for 22 of 30 (73{\%}) indicators; most notably for measurement processes such as peripheral pulses check and neuropathy testing for diabetes, and cholesterol measures for stroke. Among people with dementia, women, those in care homes, and those with fewer comorbid physical conditions and medications were associated with lower scores for overall quality of vascular care.Conclusion The quality of medical care provided to people with dementia with regard to vascular diseases is not concordant with quality, as defined by the QOF. Research is needed to improve access to high-quality care",
author = "Amanda Connolly and Stephen Campbell and Ella Gaehl and Steve Iliffe and Richard Drake and Julie Morris and Helen Martin and Nitin Purandare",
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Connolly, A, Campbell, S, Gaehl, E, Iliffe, S, Drake, R, Morris, J, Martin, H & Purandare, N 2013, 'Under-provision of medical care for vascular diseases for people with dementia in primary care: A cross-sectional review', British Journal of General Practice, vol. 63, no. 607, pp. 1-9. https://doi.org/10.3399/bjgp13X663046

Under-provision of medical care for vascular diseases for people with dementia in primary care: A cross-sectional review. / Connolly, Amanda; Campbell, Stephen; Gaehl, Ella; Iliffe, Steve; Drake, Richard; Morris, Julie; Martin, Helen; Purandare, Nitin.

In: British Journal of General Practice, Vol. 63, No. 607, 2013, p. 1-9.

Research output: Contribution to journalArticle

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T1 - Under-provision of medical care for vascular diseases for people with dementia in primary care: A cross-sectional review

AU - Connolly, Amanda

AU - Campbell, Stephen

AU - Gaehl, Ella

AU - Iliffe, Steve

AU - Drake, Richard

AU - Morris, Julie

AU - Martin, Helen

AU - Purandare, Nitin

PY - 2013

Y1 - 2013

N2 - Background Vascular diseases contribute to the causation and progression of clinical dementia.Aim To evaluate the quality of medical care for vascular diseases provided to people with dementia, the patient and practice characteristics that influence quality, and to compare care with that provided to those without dementia.Design and setting Observational, cross-sectional review of primary care records of people with dementia from 52 general practices from five primary care trusts in the UK, and comparison with publicly available summary data on patients without dementia.Method A total of 700 patients with ≥1 diagnosed vascular disease or risk factor were identified from dementia registers. Quality of care was measured on 30 indicators from the UK Quality and Outcomes Framework (QOF) for hypertension, coronary heart disease, stroke, diabetes mellitus, atrial fibrillation, heart failure, and smoking. Overall quality of vascular care was calculated for each patient with dementia.Result Level of care received by people with dementia was significantly lower compared with those without dementia for 22 of 30 (73%) indicators; most notably for measurement processes such as peripheral pulses check and neuropathy testing for diabetes, and cholesterol measures for stroke. Among people with dementia, women, those in care homes, and those with fewer comorbid physical conditions and medications were associated with lower scores for overall quality of vascular care.Conclusion The quality of medical care provided to people with dementia with regard to vascular diseases is not concordant with quality, as defined by the QOF. Research is needed to improve access to high-quality care

AB - Background Vascular diseases contribute to the causation and progression of clinical dementia.Aim To evaluate the quality of medical care for vascular diseases provided to people with dementia, the patient and practice characteristics that influence quality, and to compare care with that provided to those without dementia.Design and setting Observational, cross-sectional review of primary care records of people with dementia from 52 general practices from five primary care trusts in the UK, and comparison with publicly available summary data on patients without dementia.Method A total of 700 patients with ≥1 diagnosed vascular disease or risk factor were identified from dementia registers. Quality of care was measured on 30 indicators from the UK Quality and Outcomes Framework (QOF) for hypertension, coronary heart disease, stroke, diabetes mellitus, atrial fibrillation, heart failure, and smoking. Overall quality of vascular care was calculated for each patient with dementia.Result Level of care received by people with dementia was significantly lower compared with those without dementia for 22 of 30 (73%) indicators; most notably for measurement processes such as peripheral pulses check and neuropathy testing for diabetes, and cholesterol measures for stroke. Among people with dementia, women, those in care homes, and those with fewer comorbid physical conditions and medications were associated with lower scores for overall quality of vascular care.Conclusion The quality of medical care provided to people with dementia with regard to vascular diseases is not concordant with quality, as defined by the QOF. Research is needed to improve access to high-quality care

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JO - Journal of the Royal College of General Practitioners

JF - Journal of the Royal College of General Practitioners

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