Attitudes and Practices towards the use of technology‐screening tools, diagnosis, and management of cognitive impairment in primary care
Arianna Almirall‐Sanchez, Arianne Rodriguez‐Velasco, Jorge J Llibre‐Guerra, Ana M Rodriguez‐Salgado, Ana Ibis Peñalver, Juan J Llibre Rodriguez- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Geriatrics and Gerontology
- Neurology (clinical)
- Developmental Neuroscience
- Health Policy
- Epidemiology
Abstract
Background
Previous studies in the Cuban population suggest that Alzheimer’s Disease and related dementias (ADRD) are under‐diagnosed at primary care relative to population estimates. Recent interventions aimed to introduce the use of technology based cognitive assessments have been validated for primary care (e.g., Brain Health Assessment).However, the implementation of newly develop tools depends on the Primary care providers’ (PCPs) barrier and attitudes toward the diagnosis and management of patients with ADRD at a primary care level. Here we aimed to assess PCPs’ attitudes towards ADRD diagnosis, and the use of technology based cognitive assessments.
Method
84 PCPs were randomly selected form 10 primary care clinics. Sample size include a wide range of PCPs, including: family medicine (n = 54), neurologist (n = 2), psychiatrists(n = 13), psychologists(n = 10), clinicians (n = 3) and geriatricians (n = 2)). A questionnaire on Dementia assessment and management in primary care settings was administered to the participants. Descriptive statistics were employed for summarizing the data. Kruskal Wallis association test was utilized for determining associations between provider characteristics and outcomes.
Results
Most participants were female (n = 64, 76.2%), over 50 years old (n = 36, 52.9%) and family medicine practitioners (64.3%). The average number of patients consulted per month by PCPs were 250 (CI95% 250‐367) and over 60% of them were 55 years or older. Most of the PCPs (n = 63, 75.0%) will not refer patients with suspected ADRD if they had the training and instruments and technologies for the diagnosis at a primary care level. Lack of time (n = 59, 70.2%) and lack of confidence in their abilities (n = 68, 81.0%) were the most cited barriers for the diagnosis and management of ADRD . Around 80.0% of the interviewed practitioners considered the use of technology based cognitive assessments as important or very important tool for ADRD diagnosis. The positive attitudes of the PCPs for using technologies were correlated with the municipalities where they work (p = 0.01) and the continuous professional development of the PCPs (p = 0.03).
Conclusion
There are still barriers for the diagnosis of ADRD at a primary care level. Though PCPs are willing to implement technology based cognitive assessments in their daily practice, addressing existing barriers is key for success