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Health Series: Research Spotlight

Empowering patients to present early to GPs does not lead to earlier dementia diagnosis

Study finds that a personal letter and evidence-based leaflet from GPs doesn't improve timely access to dementia services

by George Wigmore (Senior Communications Officer)

Encouraging patients with potential memory issues to visit doctors for advice did not lead to an increase in dementia diagnoses, according to a new study from researchers at City, University of London and UCL.

In particular, the team found that despite sending patients over 70 a personal letter from their GP surgery along with an evidence-based leaflet about overcoming barriers to accessing help for memory problems, it did not change the behaviour of the GPs and lead to more referrals to memory services or for earlier overall diagnosis of dementia.

As a result, the researchers suggest that future interventions should be targeted at both patients and GPs to ensure early dementia diagnoses. The paper is published in PLOS Medicine.

In the UK around 850,000 people in UK have dementia, which mainly affects people over 65. As a result, early diagnosis of dementia are important as it allows patients and families to plan for the future, receive symptomatic treatment, access social and voluntary care, and delays care home entry.

To determine whether reaching out directly to patients could lead to earlier diagnoses of dementia, the researchers recruited 22 general practices in South-East England. During the trial,  with 11 practices – with a total of 6,387 patients over 70 - sent out a letter and information leaflet, while the other 11 – which had a total of 8,171 patients of 70 - acted as a control and maintained usual care practices.

Despite a significant increase in the proportion of patients in the intervention practices consulting their GPs with suspected memory problems compared to control practices there was no difference in proportion of patients who were referred to memory specialist clinics by the GPs. It is suggested that this may have happened either due to the increased number of visits from ‘worried well’ not displaying memory issues, or the problems being missed by the GPs.

Dr Juanita Hoe, who co-authored the study while at UCL and is currently a Senior Lecturer in Mental Health Nursing in the School of Health Sciences at City, University of London, said:

In our study we found that empowering patients using a GP's personal letter plus evidence-based leaflet is not by itself enough to improve timely access to dementia services. It is not clear why this happened, but it could be that the extra patients were either ‘worried well’ without memory problems, or alternatively that they had memory problems which were not recognised by their GP. In the future in order to increase early diagnosis benefits, and for patients to receive the benefits, interventions could target both public and practitioners.

Read the full paper

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