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. 2022 Sep 20;23(1):242.
doi: 10.1186/s12875-022-01829-1.

A new model for general practice-led, regional, community-based, memory clinics

Rebecca Disler  1   2 , Amy Pascoe  3 , Holly Anderson  4 , Ewa Piejko  4   5 , Adel Asaid  4 , Peter Disler  6   4   5
Affiliations

A new model for general practice-led, regional, community-based, memory clinics

Rebecca Disler et al. BMC Prim Care. .

Abstract

Background: Dementia is a major international health issue with high impact on the patient, relatives, and broader society. Routine screening for dementia is limited, despite known benefit of early detection and intervention on quality of care and patient outcomes. Screening is particularly limited in rural and regional areas, despite high burden and projected growth of dementia in these populations. The current study aimed to implement a new general practitioner (GP) led, multidisciplinary, model of care providing dementia detection and referral pathway to a community-based specialist clinic across six regional general practices.

Methods: Cross-sectional analysis of dementia screening and referral characteristics in the St Anthony Family Medical Practices group based in the regional area of Loddon-Mallee, Victoria. Data were collected on demographics and relevant medical history. Cognitive state was assessed using the Mini-Mental State Examination (MMSE), GP Assessment of Cognition (GPCog), and Geriatric Depression Scale (GDS). Referrals and referral outcomes were recorded for geriatrician, psycho-geriatrician, or both.

Results: Eight hundred and eighteenth patients over 65 years were screened, accounting for approximately 24.2% of 65 and over presentations for the practice network. Of those screened, 68.9% were indicated for referral and 30.3% of these were successfully referred. Of the indicated patients who received referrals, 34.2% declined. Many who declined referral had intermediate scores on the cognitive assessments utilized.

Conclusion: Standardised models of care, integrated within community services, are necessary to improve access to early detection, referral and quality management of dementia. The St Anthony Memory Service model will be invaluable in informing future service development, and in particular the development of services for people living with dementia in rural and regional communities.

Keywords: Dementia; Dementia screening; General practice; Models of care; Primary care.

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Conflict of interest statement

Dr Asaid and Dr Piejko have a financial interest in St. Anthony Family Medical Practices Pty Ltd, in which St Anthony Memory Service is run. All other authors have no conflicts of interest to declare.

References

    1. Australian Institute of Health and Welfare. Dementia in Australia 2021: Summary report. Cat. no. DEM 3. Canberra: AIHW; 2021.
    1. Access Economics. Keeping dementia front of mind: incidence and prevalence 2009–2050. Alzheimer’s Australia. 2009. https://www.dementia.org.au/sites/default/files/20090800_Nat__AE_FullKee.... Last accessed 9th November 2018.
    1. Australian Institute of Health and Welfare. Dementia. Canberra: AIHW; 2020.
    1. Gardiner F, Gale L, Ransom A, Laverty M. Looking Ahead: Responding To The Health Needs Of Country Australians In 2028 – The Centenary Year Of The RFDS. Canberra: The Royal Flying Doctor Service; 2018.
    1. Comas-Herrera A, Guerchet M, Karagiannidou M, et al. World Alzheimer Report 2016 - Improving healthcare for people living with dementia: Coverage, quality and costs now and in the future. Alzheimer's Disease International. 2016.

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