Primary care preparedness to care for patients with ADRD: A national survey study

Abstract

Introduction: It is unknown how prepared primary care practices are to deliver recommended dementia care.

Methods: A nationally representative survey of US primary care practices focused on care delivery processes, including those for patients with Alzheimer's disease and related dementias (ADRD).

Results: A total of 1245 of 3498 practices (36%) responded. Most practices reported systems to detect patients with ADRD (67%) and refer patients for diagnostic testing (75%). Fewer required ADRD-related training (45%-46%) or maintained an ADRD registry (29%). Practices that scored higher on ADRD care preparedness were more likely to be smaller, receive a higher proportion of revenue from Medicare, and have other important practice capabilities.

Discussion: Primary care practices have mixed preparedness to care for patients with ADRD. Efforts to boost ADRD preparedness, including providing adequate infrastructure and resources directly to primary care, should be a priority to address disparities in diagnosis and to optimize the patient and caregiver journey.

Highlights: Mixed ADRD preparedness identified in primary care practices across the United States. Practices often lack ADRD-specific registries and staff training initiatives. Medicare-reliant and larger physician-owned groups show higher ADRD preparedness. FQHCs reported lower ADRD preparedness, highlighting potential gaps in care. Cultural awareness and other support services correlate with better ADRD readiness.

Keywords: ADRD; ADRD preparedness; Alzheimer's disease; Alzheimer's disease and related dementias; dementia; primary care; primary care preparedness.

FIGURE 1

Flow of sample and respondent practices.

FIGURE 2

Level of preparedness of primary care practices for ADRD care. ADRD, Alzheimer's disease and related dementias.

FIGURE 3

Distribution of weighted 0–5 ADRD score. ADRD, Alzheimer's disease and related dementias.