Emma Ladds, final year medical student & Dr Kamal Mahtani, Deputy Director CEBM publish in Primary Health Care: Open Access

Background: The United Kingdom [UK] and Denmark have similarly-structured health systems utilizing GPs as the access point to care. In both countries, National Dementia Strategies emphasize the importance of GPs in early diagnosis and management of dementia. A comparison of experiences could identify similarities and differences in the approach to identifying dementia, imparting the diagnosis to the patient and management strategies. These themes could then aid future service development. Method: A defined population-sampling frame and purposive sampling strategy was used to identify 12 UK and Danish GPs. In depth, one-on-one interviews were conducted to ascertain their current practice around diagnosing dementia, informing the patient and managing the condition and their general views towards the disease itself. These were transcribed verbatim and analysed thematically for similarities and contrasting opinions.

Results: The lack of sensitive, specific tests for early dementia presents a diagnostic challenge for GPs.UK GPs expressed ambivalence towards the principle of diagnosis. Service coordination and communication were identified as major challenges to management in both countries and dementia was unequivocally viewed as stigmatizing.

Conclusion: This study demonstrates heuristic significance, highlighting the need for a diagnostic framework that empowers GPs to make the best use of imperfect diagnostic tests for early dementia, whilst encouraging the continual improvement of such cognitive assessments and further work exploring how best a proactive coordination of care services may be facilitated. A deeper analysis is required to understand the ambivalence of UK GP to early diagnosis of dementia, along with an exploration of factors in both countries that may contribute to stigma associated with the condition and how this impacts on help-seeking behaviour and service provision.

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