Use of preventive home visits by general practitioners in patients diagnosed with dementia

Abstract

Introduction: The prevalence of dementia is estimated to increase due to a growing elderly population. Patients with dementia are vulnerable as they are less likely to consult their general practitioner (GP). According to Danish guidelines, they are considered frail and in need of a proactive approach in the form of an annual preventive home visit (PHV). The aim of this study was to describe and analyse the use of PHVs among patients with dementia in general practice.

Methods: This was a quantitative descriptive quality assurance study of elderly patients (≥ 75 years) identified with dementia by their GP. During a four-week audit in 2015, 40 general practices registered all elderly patients who saw their GP or received a home visit, using a registration form addressing frailty characteristics.

Results: The study included 3,098 elderly patients among whom 214 had been identified with dementia. Patients with dementia received more PHVs than dementia-free patients. Even so, more than 60% of the patients with dementia had not received the recommended PHV within the past year. Walking distance < 100 m and > 1 chronic disease alongside dementia were associated with receiving a PHV. Substantial variation was found among the general practices with regard to conducting PHVs.

Conclusions: GP's adherence to guidelines for patients identified with dementia leaves room for improvement as a significant part of the patients had not received the annual PHV as recommended in the guidelines. Furthermore, substantial variation between general practices indicates that not all GPs need to improve to the same extent.

Funding: The study was supported by the Quality Improvement Committee for General Practice in the Region of Southern Denmark, Audit Project Odense and the University of Southern Denmark.

Trial registration: not relevant.