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Hoe handelt de Vlaamse huisarts bij dementie?

Publication date: 2016-01-01
Publisher: ACHG KULeuven; Leuven

Author:

Despriet, Deplhine
Van de Putte, Elien ; Van Eecke, Herlinde ; Steyaert, Jan ; Schoenmakers, Birgitte ; De Lepeleire, Jan

Abstract:

OBJECTIVE: In 2015, research showed that there is still a lot of discussion concerning the approach of dementia among general practitioners (GPs) in the region Zuiderkempen. The following study examines how GPs in Flanders deal with dementia in terms of detection, diagnosis, care diagnosis and treatment. METHODS: An online survey was sent by mail to 5113 Flemish GP’s. Data were collected from February 10 to March 12, 2016 and processed by means of Excell and SAS / STAT . RESULTS: 331 GPs completed the survey in full (response rate 6.47%). The results are representative for the GPs of the Flemish Region qua distribution across the provinces and university of graduation (chi-square test of goodness of fit, p-value 0.70 and 0.10 respectively). 3,02% use the OLD-scale frequently, 82,78% the MMSE and 5,44% the DSM criteria. A blood analysis is performed often by 80,97%, a head CT by 23.56% and a head MRI by 17,22%. 9 of the 331 respondents map the care diagnosis completely. The Katz scale is used rarely or never by 25,38% , the Lawton scale rarely of never by 91,54%. 91,69% enquires the physical condition of the caregivers, 96,92% the mental state. Acetylcholinesterase inhibitors are prescripted by 94,56%, memantine by 57,70%, Ginkgo Biloba by 49,85% and vitamin E by 14,20%. 89,73% prefers a medical approach for hallucinations and delusions, 65,26% for aggression, 50,78% for agitation, 71,30% for depression and 48,34% for sleep disorders. CONCLUSION: Several results are disappointing. GPs are unfamiliar with the detection and diagnostic possibilities. They do heteroanamnesis well, but use the support tools , biochemistry and imaging too little. The mapping of the care diagnosis is insufficiently, nevertheless they focus well on the caregivers. In the pharmacological treatment there is a notable discrepancy between what doctors think and do. Pharmacological policy in BPSD (Behavioural and Psychological Symptoms of Dementia) is prefered. GPs value the possibility of receiving support by reference physicians high.